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Management of open-angle glaucoma in cataract patients: phacoemulsification and Schlemm’s canal dilation using Kumar’s stainless steel spiral Schlemm’s canal expander – long term results

Poster Details

First Author: V.Kumar RUSSIA

Co Author(s):    M. Frolov   G. Dushina   A. Shradqa              

Abstract Details

Purpose:

To analyze long term results of phacoemulsification and Schlemm’s canal (SC) dilation using Kumar’s Schlemm’s canal expander (SCE) in decreasing intraocular pressure (IOP) and hypotensive medication(s) use in cataract patients suffering from open angle glaucoma (OAG).

Setting:

Ophthalmic unit of Skhodnya city hospital, Moscow province; People’s friendship university of Russia Medical Institute Department of Ophthalmology, Moscow, Russian Federation.

Methods:

Medical records of 45 patients having undergone implantation of SCE during cataract surgery between May, 2014 and October, 2015 were retrospectively evaluated. The 5 mm long spiral device, made from 0.05mm thick medical grade stainless steel wire, having inner lumen diameter of .15mm and outer - .25mm was implanted into SC ab externo after completion of cataract surgery. Outcome measures: IOP change, number of glaucoma medications and complications. Success rates were evaluated using World Glaucoma Association's guidelines. A paired t-test was used for analysis. Results were significant when p less than .05. Follow-up - more than 1 year.

Results:

Baseline mean IOP was 21.4+/–5.0mmHg and mean number of medications - 2.4+/–1.0. At 3(n=45), 6(n=44), 12(n=44) and 18 months (n=13) mean IOP reduced by 42.1+/–18.9, 41.2+/–18.3, 43.2+/–18.5 and 32.8+/–27.1% and was 11.9+/–3.4(p=1.07E-14), 11.9+/–2.7(p=3.08E-14), 11.5+/–3.1(p=3.08E-14) and 13.5+/–5.2mmHg (p=.0024); use of medications reduced to .2+/–.6(p=4.4E-16), .3+/–.7 (p=4.04E-15), .5+/–.9(p=8.5E-11) and 1.1+/–1.2(p=.019); complete success achieved in 84.4(38/45), 79.5(35/44), 68.2(30/44) and 53.8%(7/13) cases respectively. There were 3 failure cases (6.7%), 1 case after 3 months after operation and 2 cases after 18 months of follow-up.

Conclusions:

In long terms ab externo implantation of Kumar's stainless steel spiral SCE was safe to implant during cataract surgery. It was effective in decreasing IOP from the baseline and hypotensive medication use in cataract patients suffering from OAG.

Financial Disclosure:

NONE

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