More recently, non-penetrating procedures as deep sclerectomy with or without an intrascleral implant as well as viscocanalostomy
have been developed as alternatives to trabeculectomy with lesser rate of complications.
Moreover, the UBM findings of pooled supraciliary aqueous after viscocanalostomy
support the theory for increased uveoscleral outflow following the nonpenetrating procedures .
To date, there are few published papers comparing canaloplasty to other surgical procedures, and in those few available, it is being compared to trabeculectomy, to viscocanalostomy
, or to Hydrus.
They discuss trabeculectomy, deep sclerectomy, glaucoma drainage device surgery, postoperative management of filtering procedures, the role of the ocular surface, and modulation of scarring processes in glaucoma surgery; new devices and techniques, including laser-assisted techniques, viscocanalostomy
and canaloplasty, and ab interno Schlemm's canal surgery; and surgical approaches to angle-closure glaucoma, concomitant cataract and glaucoma, pediatric glaucoma, and refractory glaucoma.
versus trabeculotomy ab externo in primary congenital glaucoma: 1-year follow-up of a prospective controlled pilot study.
There are many types of intraocular surgeries such as phacoemulsification, trabeculectomy, deep sclerotomy, viscocanalostomy
, holmium laser sclerostomy, deep anterior lamellar keratoplasty, endothelial keratoplasty, intracorneal ring segment implantation, and pars plana vitrectomy, that are known to result in DMD.
Other surgical options may also be considered for patients unsuitable for medical therapy, such as tube shunts, viscocanalostomy
(causing dilation of Schlemm's canal) or a deep sclerectomy (resulting in removal of the inner wall of Schlemm's canal and the juxta-canalicular trabecular meshwork alleviating the majority of outflow resistance).
Canaloplasty is a relatively new nonperforating blebless technique, quite similar to Stegmann's viscocanalostomy
, in which a 10-0 prolene suture is positioned and tensioned within Schlemm's canal after the injection of a small amount of high viscosity sodium hyaluronate, thus facilitating aqueous outflow through natural pathways (collectors channels and aqueous veins) [2-12].
Nonpenetrating glaucoma surgery avoids the complications of trabeculectomy and yields comparable effect on lowering IOP especially if combined with other step, for example, use of mitomycin C, trabeculotomy, collagen implant, viscocanalostomy
, or Ex-PRESS mini shunt  (Alcon Inc., Fort Worth, TX).
Before the Eyepass device is implanted in both lumina of the Schlemm canal, the openings on both sides of the canal are dilated by gentle injection of an OVD such as sodium hyaluronate 1.0% [Healon] through a viscocanalostomy
Dilation of Schlemm's canal in viscocanalostomy
: comparison of 2 viscoelastic substances.
PubMed and EMBASE were searched for literatures published up to April 1, 2016, in any language with the following strategies: ((circumferential OR 360) AND (viscocanalostomy
OR viscodilat*)) OR canaloplasty.