Canaloplasty

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].