Assessing Efficacy of Canaloplasty Using Continuous 24-Hour Monitoring of Ocular Dimensional Changes

• Published in: Investigative ophthalmology & visual science Vol. 57; no. 6; p. 2533
• Main Authors: Rekas, Marek, Danielewska, Monika E., Byszewska, Anna, Petz, Katarzyna, Wierzbowska, Joanna, Wierzbowski, Robert, Iskander, D. Robert
• Format: Journal Article
• Language: English
• Published: United States 01.05.2016
• Subjects: Aged; Circadian Rhythm; Female; Filtering Surgery - methods; Follow-Up Studies; Glaucoma, Open-Angle - diagnosis; Glaucoma, Open-Angle - physiopathology; Glaucoma, Open-Angle - surgery; Humans; Intraocular Pressure - physiology; Limbus Corneae - anatomy & histology; Male; Monitoring, Physiologic - methods; Organ Size; Postoperative Period; Prospective Studies; Time Factors; Visual Acuity
• ISSN: 1552-5783; 0146-0404; 1552-5783
• DOI: 10.1167/iovs.16-19185

We investigated whether 24-hour monitoring of corneoscleral limbus area (CSLA) with the Sensimed Triggerfish contact lens sensor (CLS) can be used clinically to assess midterm efficacy of canaloplasty and to assess the relationships of CSLA changes with the heart rhythm. Ten eyes of 10 patients, with POAG, which were qualified either to canaloplasty or canaloplasty and phacoemulsification, were included in this study. Eyes were washed out before the surgery and control visits were done at days 1, 7, and 3, 6, 12 months postoperatively, at which subjects were examined. We performed 24-hour monitoring of CSLA changes and Holter ECG at washout, and at 3- and 12-month postop visits. Raw CLS signals were processed to lead two parameters describing short-term 24-hour variability of CSLA (VAR, â). Heart activity parameters from CLS were compared to those acquired from Holter ECG. Mean post washout IOP was 20.6 ± 4.7 and decreased to 14.2 ± 3.0 mm Hg 1 year after surgery (P < 0.01). A decreasing trend in VAR and â parameters were noted. Statistically significant differences were found between the washout and 3-month postop visit for VAR and â (P = 0.014 and P = 0.027, respectively) as well as between the washout and 12-month postop result for the parameter â (P = 0.031). No statistically significant differences were found between the 3- and 12-month postop results for both considered parameters. Canaloplasty alone or combined with cataract surgery is a successful surgical method of lowering IOP in glaucoma patients. Canaloplasty decreases 24-hour CSLA fluctuation pattern measured with CLS.