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Combined ab externo Schlemm’s canal surgery in management of open-angle glaucoma in cataract patients

Poster Details

First Author: G.Dushina RUSSIA

Co Author(s):    V. Kumar   M. Frolov   A. Bezzabotnov   A. Shradqa           

Abstract Details


To evaluate the effectiveness of segmental Schlemm’s canal (SC) distension using Kumar’s 3nd generation Schlemm’s canal expander (SCE) in decreasing intraocular pressure (IOP) in cataract patients suffering from open angle glaucoma (OAG).


People's friendship university of Russia (RUDN University) Medical Institute Department of Ophthalmology, Moscow; unit of Skhodnya city hospital, Moscow province, Russia.


Results of Kumar’s 3nd generation SCE implantation into a segment of SC in 39 patients during combined surgery for cataract and OAG were retrospectively analyzed. The 5 mm long spiral device made from 0.05mm thick medical grade stainless steel wire (inner lumen diameter 0.15mm, outer 0.25mm) was implanted into SC ab externo after completion of cataract surgery. Inclusion criteria were OAG having high IOP on maximum hypotensive medication(s) and minimum follow-up period not less than 24 months. Outcome measures were IOP change, number of glaucoma medications pre- and postoperatively and complications.


Mean preoperative IOP was 22.3+/–4.8 mmHg (95%CI 20-23.9) and mean number of medications 2.5+/–0.9 (95%CI 2.2-2.8). At 24 months, there was a reduction in mean IOP by 25.3 % and IOP decreased to 13.2+/–2.5mmHg (95%CI 9.7-17). Use of medications reduced to 1+/–1(95% CI .2-2.2). complete success  was achieved by 61.5% (24/39) cases without use of hypotensive medications and by 30.8% (12/39) with medication, failure - 7,7% (3/39)  In another 3 case (7.7%) YAG laser trabeculopuncture was required to control IOP. During the follow up period not a single case of inflammation, of hypotony, or shallow chamber was observed.


Results of combined surgery – phacoemulsification with intraocular lens implantation and Kumar’s 3nd generation SCE implantation in surgical management of OAG in cataract patients show significant reduction in IOP from the baseline and in hypotensive medication(s) use.

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