Clinical evaluation of the aqueous outflow system in XXXX for canaloplasty.

@entity1 @entity725 @entity1503 @entity941
PURPOSE: To assess the aqueous outflow pathway in @entity725 ( @entity725 ) through provocative gonioscopy and channelography with a flexible microcatheter and @entity941 tracer during canaloplasty. METHODS: One eye each was randomly selected from 28 consecutive black African @entity725 @entity1 undergoing canaloplasty. Provocative gonioscopy was performed at the beginning of surgery, and @entity1503 from collector channels into Schlemm's canal (SC) was semiquantitatively evaluated. During canaloplasty, a flexible microcatheter injected @entity941 tracer stepwise into SC. The outflow pathway parameters of interest were @entity1503 , transtrabecular passage of @entity941 , and episcleral vein filling. RESULTS: Mean age, intraocular pressure (IOP), and cup-to-disc ratio were 45.9 years (SD +/- 13.3), 41.0 mm Hg (SD +/- 11.9), and 0.78 (SD +/- 0.22), respectively. Mean IOP (P < 0.001) and episcleral venous egress (P = 0.01) correlated significantly with @entity1503 , but cup-to-disc ratio (P = 0.71), age (P = 0.70), and @entity941 diffusion (P = 0.90) did not. A multinomial regression model showed that higher IOP (P < 0.001, OR, 1.687; 95% CI, 1.151-2.472) was strongly associated with poor @entity1503 , independent of the @entity1 's age (P = 0.383, OR, 0.942; 95% CI, 0.823-1.078). No correlation was found between preoperative IOP, transtrabecular passage, episcleral venous egress, and cup-to-disc ratio. The mean IOP was 17.5 mm Hg (SD +/- 3.7) 6 months after surgery. The level of IOP after surgery correlated with the grade of @entity1503 and episcleral venous egress (P < 0.001). CONCLUSIONS: High mean IOP may be associated with poor @entity1503 and filling of SC. A collapsed canal, probably secondary to high IOP, may be an underestimated sign in black African @entity1 with @entity725 . The quality of @entity1503 and episcleral venous egress may both be predictive of the level of IOP after surgery. Provocative gonioscopy and channelography may reflect the function of the outflow pathway and may be helpful in assessing the surgical outcome of canaloplasty.
