[Comparison of trabeculectomy and canaloplasty : Pressure reducing effect and postoperative interventions/complications].

BACKGROUND: Trabeculectomy (TET) is still the most commonly performed surgical treatment in dealing with primary open angle glaucoma (POAG) worldwide. Canaloplasty (CP) as a nonpenetrating surgical procedure has recently become a new option to efficiently reduce intraocular pressure (IOP).

OBJECTIVES: This study compared both surgical procedures concerning the efficacy in IOP reduction. Furthermore we compared IOP fluctuation, postoperative medication, visual acuity, astigmatism and postoperative interventions and complications.

MATERIALS AND METHODS: Retrospectively studied were 32 eyes after canaloplasty and 31 eyes after trabeculectomy. IOP, IOP fluctuation range, visual acuity, astigmatism and glaucoma medication were recorded preoperatively and after a follow-up of 6 and 12 months. In addition we compared postoperative complications and interventions of both surgical procedures.

RESULTS: The mean IOP after canaloplasty was significantly reduced from 16.0 ± 3.5 mm Hg to 12.5 ± 3.3 mm Hg. Trabeculectomy also achieved a significant IOP reduction from 15.3 ± 3.5 mm Hg to 11.0 ± 2.6 mm Hg. Comparing the two surgical procedures there was no evidence for a significant difference in IOP reduction. Trabeculectomy was able to reduce the number of postoperative glaucoma medication substances better than canaloplasty. There was no difference in postoperative visual acuity or astigmatism. Concerning postoperative complications and interventions canaloplasty treatment was associated with a less severe spectrum of complications.

CONCLUSION: Both procedures provide a safe and efficient IOP reduction. Trabeculectomy is able to achieve an even better IOP reduction without application of additional postoperative medication. Canaloplasty requires shorter inpatient stay, less frequent postoperative checkups and interventions as well as a less severe spectrum of complications.