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. 2022 Dec 8;11(24):7279.
doi: 10.3390/jcm11247279.

Intraocular Pressure Fluctuation in Primary Open-Angle Glaucoma with Canaloplasty and Microcatheter Assisted Trabeculotomy

Chen Xin  1 , Ningli Wang  1 , Huaizhou Wang  1
Affiliations

Intraocular Pressure Fluctuation in Primary Open-Angle Glaucoma with Canaloplasty and Microcatheter Assisted Trabeculotomy

Chen Xin et al. J Clin Med. .

Abstract

Background: Schlemm’s canal (SC) targeted procedures constitute a promising therapy for open angle glaucoma (POAG), safer and less invasive. However, little attention was paid to the intraocular pressure (IOP) variation in patients receiving these procedures, which is the risk factor for POAG progression. This study is to evaluate the IOP variation in eyes with POAG after modified canaloplasty (MC) and microcatheter assisted trabeculotomy (MAT). (2) Methods: POAG with good IOP in office hours after MC or MAT and age-matched normal subjects were recruited in this prospective coherent study. IOP in sitting and supine positions and 24-h IOP was measured. Aqueous vein and blood reflux into the SC were examined. (3) Results: Among 20 normal subjects, 25 eyes with MC eyes and 30 eyes with MAT were recruited in this study. Aqueous veins are frequently located in the inferior nasal quadrants in all groups. No pulsatile signs were observed in an aqueous vein in the MAT group but they were observed in 68% of the MC group. Blood reflux in the SC could be seen in all the operated eyes. The IOP in the sitting position was not significant different among groups (p = 0.419). Compared to normal, the IOP increased dramatically after lying down for 5 min in the MC and MAT groups (PMC vs. normal = 0.003, PMAT vs. normal = 0.004), which is similar for IOP change after lying down for 60 min (PMC vs. normal < 0.001, PMAT vs. normal < 0.001). In terms of diurnal IOP, subjects were stable in the MAT group (p < 0.01), variable in the normal group (p = 0.002), and most fluctuant in MC group (p < 0.001). (4) Conclusions: MC and MAT reduce the IOP but present aberrant short-term IOP regulation, which should be paid attention to in clinical settings.

Keywords: IOP fluctuation; Schlemm’s canal; canaloplasty; primary open angle glaucoma; trabeculotomy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Aqueous vein distribution in eyes. Note: MAT: microcatheter assisted trabeculotomy; IT: inferior temporal; IN: inferior nasal; ST: superior temporal; SN: superior nasal.
Figure 2
Figure 2
Comparison of intraocular pressure changes induced by postural alterations. Note: CP: canaloplasty, MAT: microcatheter assisted trabeculotomy. ΔIOP Supine 5-sit: The IOP difference between subjects lying for 5 min and in sitting position, ΔIOP Supine 60-sit: The IOP difference between subjects lying for 60 min and in sitting position, ΔIOP Supine 60-5: The IOP difference between subjects lying for 60 min and lying for 5 min.
Figure 3
Figure 3
Diurnal IOP in different groups. Note: MC: modified canaloplasty; MAT: microcatheter assisted trabeculotomy, IOP: intraocular pressure.
See this image and copyright information in PMC

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