What If The Canal Is Not Fully Catheterized?
What if the canal cannot be fully catheterized by the iTrack catheter during canaloplasty? Well, for canaloplasty to be fully effective, the canal really does need to be fully catheterized so that a suture can be placed through the canal and then tied to stent open the canal. Now, that being said, there are occasions when the surgeons simply cannot get the catheter all the way around the canal. Such situations can include prior surgery – be it laser or other ocular surgery – or even just many many years of glaucoma drop use.
In any case, if the catheter is not able to be positioned fully through the canal, the surgery can still be quite successful. Conversion to viscocanalostomy which has been around for over twenty years can be done. Viscocanalostomy is essentially canaloplasty without a suture. So gel is still use to dilate the canal, and then, the flap that is created to get to the canal is closed. But fluid, generally, is better able to move from the inside of the eye into the natural drainage canal, once it has been dilated with that viscoelastic gel.
A recent study that looked at viscocanalostomy patients seven years out from surgery was very encouraging. Many of those patients has a sustained reduction in pressure of up to 30%. So, even when canaloplasty cannot be fully completed, the alternative surgery – viscocanalostomy, can often be done and still good results can be achieved.
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