Steps of Canaloplasty
1- Partial thickness scleral flap near the limbus (cornea-scleral junction) is performed.
2- The Canal of Schlemm is identified then intubated with a small tube or microcatheter. This tube has several characteristics which are:
- A diameter of 200 microns.
- A lighted tip to identify its location as it passes through the canal.
- A lumen to allow for the injection of viscoelastic Material (sodium hyaluronate). This material helps to force open the entire length of the canal.
3- This tube will pass 360° clockwise through the canal.
4- Once it passed the full length of canal, a 10'0 Nylon or Prolene suture is tied to the tube.
5- The tube will be pulled 360° anti-clockwise with the suture. 6- A special ultrasound imaging system can be used to identify the canal and the passage of the tube in the canal.
7- The suture will be left in place and tied off to provide tension on the trabecular meshwork which will also force the canal to open.
8- The scleral flap and the conjunctiva are tightly closed to prevent the formation of bleb and also to prevent leakage of aqueous humor.
9- A double sutures technique can also be used to reduce the risk of closure of the canal.