Advertisement

Canaloplasty

  • Gabor B. Scharioth
Chapter

Abstract

First successful antiglaucomatous surgery was performed by the German ophthalmologist Albrecht von Graefe in 1852. The described technique did work only in acute angle closure glaucoma. In the following 100 years various surgical techniques addressed open angle glaucoma problematic. Since early 1970th trabeculectomy became the standard of care in open-angle glaucoma surgery. This widely used procedure involves a surgically formed pathway for aqueous humour between the anterior chamber and the subconjunctival space to lower intraocular pressure (IOP) in treatment of glaucoma. Main goal is the formation of a conjunctival filtering bleb. This is a relatively unphysiological approach and scleral as well as conjunctival scarring led to introduction of antimetabolites as adjunctive for filtering bleb depending glaucoma surgeries. Numerous intraoperative and postoperative complications have been cited [1–5]. These include hypotony, maculopathy, blebitis/endophthlamitis, hyphema, suprachoroidal hemorrhage or effusions, encapsulation of the bleb with resultant IOP elevation, loss of visual acuity, and increased risk for cataract formation. In addition, intensive postoperative care, including bleb massage, laser suturolysis, release of releasable sutures, needling, or 5-fluorouracil injections, may be needed to achieve primary success. Recently several authors reported relatively high failure rate of trabeculectomy after long term follow-up [1].

Keywords

Anterior Chamber Trabecular Meshwork Polypropylene Suture Anterior Chamber Angle Scleral Flap 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Video 4.1

Canaloplasty (MPG 104696 kb)

Video 4.2

Canaloplasty with Onalene (MPG 177941 kb)

References

  1. 1.
    Jones E, Clarke J, Khaw PT. Recent advances in trabeculectomy technique. Curr Opin Ophthalmol. 2005;16:107–13.CrossRefPubMedGoogle Scholar
  2. 2.
    Mac I, Soltau JB. Glaucoma-filtering bleb infections. Curr Opin Ophthalmol. 2003;14:91–4.CrossRefPubMedGoogle Scholar
  3. 3.
    Borisuth NSC, Phillips B, Krupin T. The risk of glaucoma filtration surgery. Curr Opin Ophthalmol. 1999;10:112–6.CrossRefPubMedGoogle Scholar
  4. 4.
    Ophir A. Encapsulated filtering bleb; a selective review –new deductions. Eye. 1992;6:348–52.CrossRefPubMedGoogle Scholar
  5. 5.
    Gedde SJ, Herndon LW, Brandt JD, et al. Surgical complications in the tube versus trabeculectomy study during the first year of follow-up. Am J Ophthalmol. 2007;143:23–31.CrossRefPubMedGoogle Scholar
  6. 6.
    Ellingsen BA, Grant WM. Trabeculotomy and sinusotomy in enucleated human eyes. Investig Ophthalmol. 1972;11:21–8.Google Scholar
  7. 7.
    Johnstone MA, Grant WM. Microsurgery of Schlemm’s canal and the human aqueous outflow systeme. Am J Ophthalmol. 1973;76:906–17.CrossRefPubMedGoogle Scholar
  8. 8.
    Epstein E. Fibrosing response to aqueous; its relation to glaucoma. Br J Ophthalmol. 1959;43:641–7.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Krasnov MM. Externalization of Schlemm’s canal (sinusotomy) in glaucoma. Br J Ophthalmol. 1968;52:157–61.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Koslov VI, Bagrov SN, Anisimova SY, et al. (Nonpentrating deep sclerectomy with collagen) Russian. Oftalmokhirurgiia. 1990;3:44–6.Google Scholar
  11. 11.
    Fyodorov SN, Ioffe DI, Ronkina TI. Deep sclerectomy: technique and mechanism of a new antiglaucomatous procedure. Glaucoma. 1984;6:281–183.Google Scholar
  12. 12.
    Zimmerman TJ, Kooner KS, Ford VJ, et al. Trabeculectomy vs. nonpenetrating trabeculectomy: a retrospective study of two procedures in phakic patients with glaucoma. Ophthalmic Surg. 1984;15:734–40.PubMedGoogle Scholar
  13. 13.
    Stegmann R, Pinenaar A, Miller D. Viscocanalostomy for open-angle glaucoma in black African patients. J Cataract Refract Surg. 1999;25:316–22.CrossRefPubMedGoogle Scholar
  14. 14.
    Sourdille P, Santiago P-Y, Villain F, et al. Reticulated hyaluronic acid implant in nonperforating trabecular surgery. J Cataract Refract Surg. 1999;25:332–9.CrossRefPubMedGoogle Scholar
  15. 15.
    Ambresin A, Shaarawy T, Mermoud A. Deep sclerectomy with collagen implant in one eye compared with trabeculectomy in the other eye of the same patient. J Glaucoma. 2002;11:214–20.CrossRefPubMedGoogle Scholar
  16. 16.
    Sanchez E, Schnyder CC, Sickenberg M, et al. Deep sclerectomy: results with and without collagen implant. Int Ophthalmol. 1996/97;20:157–62.Google Scholar
  17. 17.
    Wiermann A, Zeitz O, Jochim E, Matthiessen ET, Wagenfeld L, Galambos P, Scharioth G, Matthiesen N, Klemm M. A comparision between absorbable and non-absorbable scleral implants in deep sclerectomy (T-Flux and SK-Gel. Ophthalmologe. 2007;104(5):409–14.CrossRefPubMedGoogle Scholar
  18. 18.
    Schreyger F, Scharioth GB, Baatz H. SKGEL implant versus T-Flux implant in the contralateral eye in deep sclerectomy with phacoemulsification: long-term follow-up. Open Ophthalmol J. 2008;2:57–61.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    O’Bart DPS, Shiew M, Edmunds B. A randomized, prospective study comparing trabeculectomy with viscocanalostomy with adjunctive antimetabolite usage for the management of open angle glaucoma uncontrolled by medical therapy. Br J Ophthalmol. 2004;88:1012–7.CrossRefGoogle Scholar
  20. 20.
    Yalvac IS, Sahin M, Eksioglu U. Primary viscocanalostomy versus trabeculectomy for primary open-angle glaucoma; three years prospective randomized clinical trial. J Cataract Refract Surg. 2004;30:2050–7.CrossRefPubMedGoogle Scholar
  21. 21.
    Carassa RG, Bettin P, Fiori M, Brancato R. Viscocanaolostomy versus trabeculectomy in white adults affected by open-angle glaucoma; a 2-year randomized, controlled trial. Ophthalmology. 2003;110:882–7.CrossRefPubMedGoogle Scholar
  22. 22.
    Kobayashi H, Kobayashi K, Okinami S. A comparision of the intraocular pressure-lowering effect and safety of viscocanalostomy and trabeculectomy with mitomycin C in bilateral open-angle glaucoma. Graefes Arch Clin Exp Ophthalmol. 2003;241:359–66.CrossRefPubMedGoogle Scholar
  23. 23.
    Cillino S, Di Pace F, Casuccio A, Lodato G. Deep sclerectomy versus punch trabeculectomy: effect of low dose mitomycin C. Ophthalmologica. 2005;219:281–6.CrossRefPubMedGoogle Scholar
  24. 24.
    Lüke C, Dietlein TS, Jacobi PC, et al. A prospective ranndomized trial of viscocanalostomy versus trabeculectomy in open-angle glaucoma: a 1-year follow-up study. J Glaucoma. 2002;11:294–9.CrossRefPubMedGoogle Scholar
  25. 25.
    Goldsmith JA, Ahmed IK, Cradall AS. Nonpenetrating glaucoma surgery. Ophthalmol Clin N Am. 2005;18(3):443–60.CrossRefGoogle Scholar
  26. 26.
    Smith R. A new technique for opening the canal of Schlemm. Br J Ophthalmol. 1960;44:370–3.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Beck AD, Lynch MG. 360° trabeculotomy for primary congenital glaucoma. Arch Ophthalmol. 1995;113:1200–2.CrossRefPubMedGoogle Scholar
  28. 28.
    Scharioth GB. Cartheterless Viscocanaloplasty, 6th Congress of Romanian Society of Ophthalmology 2007, Sinaia, Romania. and 3rd International Meeting on Innovative Glaucoma Surgery, Recklinghausen, Germany.Google Scholar
  29. 29.
    Lewis RA, von Wolff K, Tetz M, et al. Canaloplasty: circumferential viscodilation and tensioning of Schlemm’s canal using a flexible microcatheter for the treatment of open-angle glaucoma in adults: interim clinical study analysis. J Cataract Refract Surg. 2007;33:1217–26.CrossRefPubMedGoogle Scholar
  30. 30.
    Lewis RA, von Wolff K, Tetz M, et al. Canaloplasty: circumferential viscodilation and tensioning of Schlemm’s canal using a flexible microcatheter for the treatment of open-angle glaucoma in adults: Two-year interim clinical study results. J Cataract Refract Surg. 2009;35:814–23.CrossRefPubMedGoogle Scholar
  31. 31.
    Grieshaber MC. Channelography and mechanism of action in canaloplasty. Ophthalmologe. 2015;112(4):319–24.CrossRefPubMedGoogle Scholar
  32. 32.
    Scharioth GB. Glaucolight assisted Canaloplasty. Highlights Ophthalmol. 2012;40(6):2–7.Google Scholar
  33. 33.
    Scharioth GB. Risk of circumferential viscodilatation in viscocanalostomy. J Cataract Refract Surg. 2015;41(5):1122–3.CrossRefPubMedGoogle Scholar
  34. 34.
    Rękas M, Petz K, Wierzbowska J, Byszewska A, Jünemann A. Evacuating a pre-Descemet hematoma through a clear corneal incision during acanaloplasty procedure. J Cataract Refract Surg. 2014;40(12):1953–7.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Gabor B. Scharioth
    • 1
    • 2
  1. 1.Aurelios AugenzentrumRecklinghausenGermany
  2. 2.Department of Ophthalmology, Faculty of MedicineUniversity of SzegedSzegedHungary

Personalised recommendations