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Coming full circle: Canal surgery with/without implants
Author(s) -
Grieshaber M.
Publication year - 2015
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2015.0238
Subject(s) - medicine , trabecular meshwork , schlemm's canal , glaucoma , trabeculectomy , glaucoma surgery , dry needling , intraocular pressure , surgery , fibrous joint , ophthalmology , alternative medicine , pathology , acupuncture
Summary Canaloplasty, one of the latest ab externo, non‐penetrating procedures in glaucoma, reduces intraocular pressure by targeting the pathologically high resistance to aqueous outflow and restoring the natural outflow system. After (circumferential) viscodilation of Schlemm's canal, a polypropylene suture is looped through the canal and tightened to distend the trabecular meshwork; alternatively a new device, the Stegmann Canal Expander is implanted. The main advantage of canaloplasty over fistulating trabeculectomy is the independence of a filtering bleb. Furthermore, there is no need for antimetabolites and needling procedures. Canaloplasty as a stand‐alone procedure or combined cataract extraction is proven to be safe and efficient. Technically, the surgeon must understand and respect the microanatomy of the outflow system and the mechanics of the procedure itself. This presentation guides the surgeon through standard canaloplasty and the implantation of the Stegmann Canal Expander, highlights tips and pitfalls, and presents new clinical data.