A modified scleral dissection technique with suprachoroidal drainage for canaloplasty

Purpose A modified canaloplasty technique is described that may facilitate the surgical procedure and potentially maximizes the intraocular pressure (IOP)-lowering effect by altering both the trabecular and uveoscleral aqueous outflow. Methods The second deeper layer in the modified technique (about...

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Bibliographic Details
Published in:	Graefe's archive for clinical and experimental ophthalmology Vol. 254; no. 2; pp. 351 - 354
Main Authors:	Szurman, Peter, Januschowski, Kai, Boden, Karl Thomas, Szurman, Gesine Bettina
Format:	Journal Article
Language:	English
Published:	Berlin/Heidelberg Springer Berlin Heidelberg 01-02-2016 Springer Nature B.V
Subjects:	Aqueous Humor - secretion Choroid - metabolism Dissection Drainage - methods Filtering Surgery - methods Glaucoma Glaucoma - surgery Glaucoma Drainage Implants Humans Intraocular Pressure - physiology Medicine Medicine & Public Health Ophthalmology Prosthesis Implantation - methods Retrospective Studies Sclera - surgery Surgical Flaps Suture Techniques Modified technique Novel canaloplasty technique Canaloplasty Schlemm’s canal preparation
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Summary:	Purpose A modified canaloplasty technique is described that may facilitate the surgical procedure and potentially maximizes the intraocular pressure (IOP)-lowering effect by altering both the trabecular and uveoscleral aqueous outflow. Methods The second deeper layer in the modified technique (about 3.5 × 4 mm, Fig. 1a, b ) is not prepared in a lamellar fashion, but is cut down full-thickness to the choroid, hence opening the suprachoroidal space. Furthermore, this second deep scleral flap creates an additional aqueous outflow and drainage into the suprachoroidal space, thus possibly lowering the postoperative IOP by improving the natural uveoscleral outflow facility. Results Seventy-eight eyes operated with this modified technique in the last 12 months were retrospectively analysed. Mean IOP before surgery was 19.10 mmHg and patients applied 3.0 topical medications. Twelve months after surgery, the IOP was 13.5 mmHg and patients applied 1.0 topical medication; 52.6 % of patients did not use any topical therapy. Discussion The modified dissection canaloplasty technique potentially improves the IOP-lowering effect due to the creation of additional suprachoroidal drainage and simplifies the most complicated step of the surgery, as the scleral spur and the Schlemm’s canal can be located using suprachoroidal access.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0721-832X 1435-702X
DOI:	10.1007/s00417-015-3234-5