Abstract
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.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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No funding was received for this research.
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Karl Thomas Boden and Gesine Bettina Szurman contributed equally to this work.
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Szurman, P., Januschowski, K., Boden, K.T. et al. A modified scleral dissection technique with suprachoroidal drainage for canaloplasty. Graefes Arch Clin Exp Ophthalmol 254, 351–354 (2016). https://doi.org/10.1007/s00417-015-3234-5
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DOI: https://doi.org/10.1007/s00417-015-3234-5