Introduction:

Canaloplasty is an advanced surgical procedure used to treat open-angle glaucoma, a common form of glaucoma characterized by increased intraocular pressure (IOP) due to impaired drainage of aqueous humor. This comprehensive article aims to provide a detailed overview of canaloplasty, including its indications, surgical technique, benefits, and potential risks.

Understanding Canaloplasty:

Canaloplasty is a minimally invasive glaucoma surgery that aims to enhance the natural drainage system of the eye by restoring the function of the Schlemm's canal and trabecular meshwork. By creating a pathway for aqueous humor to drain more effectively, canaloplasty helps lower IOP and reduces the risk of glaucoma progression.

Indications for Canaloplasty:

Canaloplasty is typically recommended for individuals with open-angle glaucoma who have not achieved sufficient IOP control with medications or other conservative treatments. It is also considered for patients with early to moderate stages of glaucoma and those looking for a more sustainable and long-term treatment option.

The Canaloplasty Procedure:

The canaloplasty procedure involves the following steps:

• Creation of a Microscopic Incision: A small incision is made in the eye to access the Schlemm's canal.
• Catheterization of the Canal: A microcatheter is inserted into the Schlemm's canal and advanced circumferentially to dilate the canal.
• Viscodilation and Suture Placement: A sterile, gel-like substance called viscoelastic is injected into the canal to dilate and open the drainage pathway. A suture is then placed inside the canal and tied to maintain the canal's patency.
• Tensioning of the Suture: The suture is tensioned to optimize the drainage angle and enhance aqueous humor outflow.
• Sealing of the Incision: The surgical incision is closed, and the eye is allowed to heal.

Benefits of Canaloplasty:

Canaloplasty offers several advantages for individuals with open-angle glaucoma:

• Effective IOP Reduction: Canaloplasty provides significant and sustained reduction in IOP, lowering the risk of glaucoma progression and associated vision loss.
• Minimally Invasive: The procedure is minimally invasive, leading to faster recovery and reduced postoperative discomfort.
• Preservation of Conjunctiva: Unlike some traditional glaucoma surgeries, canaloplasty preserves the conjunctiva, which may be important for future glaucoma treatment options.
• Reduced Need for Medications: Successful canaloplasty may decrease or eliminate the need for glaucoma medications, improving patient convenience and compliance.

Potential Risks and Complications:

As with any surgical procedure, canaloplasty carries potential risks, including:

• Intraocular Pressure Spikes: Some patients may experience temporary spikes in IOP following surgery, which can usually be managed with medications.
• Bleeding and Infection: While rare, bleeding or infection at the surgical site can occur.
• Suture-Related Complications: In some cases, suture-related issues may require further intervention.

Conclusion:

Canaloplasty is an innovative and effective surgical option for managing open-angle glaucoma. It offers patients a safe and long-term approach to reduce intraocular pressure and preserve vision.

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