Canaloplasty in the Treatment of Uveitic Glaucoma – Results of an 18-Month Follow-up

Introduction: Uveitic glaucoma (UG) is a type of secondary glaucoma in which elevated intraocular pressure (IOP) and subsequent optic nerve damage result from a chronic inflammation of the uvea. UG is estimated to occur in approximately 20% of patients with uveitis. Due to its complex etiology UG treatment requires a highly personalized approach. In recent years, minimally invasive glaucoma surgery (MIGS) procedures, such as canaloplasty (CP), have gained recognition for their potential to effectively reduce IOP while minimizing complications associated with traditional filtration surgeries. The aim of this study was to evaluate the efficacy and safety of canaloplasty in patients with UG. Materials and Methods: This prospective study included 15 eyes with UG that received 360° ab externo canaloplasty. The main indication for surgery was the failure of maximum tolerated medical therapy. Control check-ups were conducted pre-operatively and in an 18-month follow-up time. Study endpoints involved reduction in IOP values and in the number of glaucoma medications after the intervention. Results: CP led to a significant 64 % reduction in IOP (14.44 ± 3.54 mmHg) from the preoperative baseline. The number of medications decreased significantly by 94%. Complete success (IOP < 18 mmHg) was achieved in 84% of patients, while qualified success (IOP < 21 mmHg) was observed in 92%. No severe complications were reported. The most common postoperative findings were microhyphema (46.1%) and cataract formation (23%). A recurrence of uveitis was noted in two cases (15.3%) but was successfully managed. Flare photometry measurements indicated a significant reduction in intraocular inflammation postoperatively. Conclusions: Canaloplasty proved to be an effective and safe surgical option for UG patients.