ArticleBMC ophthalmology2025
Modified suture-assisted penetrating canaloplasty vs. compound trabeculectomy in treating primary angle-closure glaucoma.
Article in BMC ophthalmology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposesTo evaluate the effectiveness and safety of a modified suture-assisted penetrating canaloplasty (SAPC) compared to compound trabeculectomy for treating primary angle-closure glaucoma (PACG).
designRetrospective comparative interventional study.
methodsWe analyzed consecutive cases of uncontrolled PACG treated at Fuzhou Eye Hospital (December 2019-April 2021) with either modified SAPC (study group) or compound trabeculectomy (control group). Postoperative evaluations occurred at 1 week and 1, 3, 6, and 12 months. Outcome measures included mean diurnal intraocular pressure (mdIOP), anti-glaucoma medication burden, surgical success rate (complete: mdIOP ≤18 mmHg without medications; qualified: mdIOP ≤18 mmHg with medications), and complications.
resultsThe final analysis included 19 eyes in the modified SAPC group and 17 eyes in the control group. At the 12-month follow-up, the SAPC group demonstrated a significant reduction in mdIOP from 20.17±6.00 mmHg to 12.38±2.60 mmHg (P<0.001), with medications reduced from 3.21±1.03 to 0.11±0.32 (P<0.001). Compared to the control group's mdIOP of 16.82±2.36 mmHg with 0.43±0.68 medications at 12 months, the modified SAPC group maintained significantly better pressure control (P<0.001). The complete success rate was substantially higher in the SAPC group (89.47% vs. 52.94%, P=0.038). Transient IOP elevation occurred in 5 eyes (26.3%) following SAPC, representing the most frequent postoperative complication. No significant vision loss or serious adverse events were observed.
conclusionModified SAPC provides effective and sustained IOP reduction with a favorable safety profile, outperforming compound trabeculectomy in PACG patients over 12 months. while minimizing medication dependence, demonstrating superior effectiveness to compound trabeculectomy with a favorable short-term safety profile. Why carry out this study? 1. This study aimed to evaluate the effectiveness and safety of a modified suture-assisted penetrating canaloplasty (SAPC) technique compared to compound trabeculectomy in treating primary angle-closure glaucoma (PACG). 2. This study addressed the limitations of high-cost microcatheters and bleb-related complications. What was learned from the study? 1. Modified SAPC demonstrated superior intraocular pressure (IOP) reduction (12.38±2.60 mmHg vs. 16.82±2.36 mmHg at 12 months) and higher complete success rates (89.47% vs. 52.94%) compared to compound trabeculectomy, with fewer complications and reduced dependence on postoperative medications. 2. The technique's cost-effective use of 5-0 polypropylene sutures and adjustable sutures simplified the procedure while maintaining high catheterization success (87.5%), offering a viable alternative for mild-to-moderate PACG. 3. Younger patients with short axial lengths showed an increased risk of malignant glaucoma post-SAPC, highlighting the need for refined surgical approaches in this subgroup.
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