2971: Canaloplasty, Trabeculotomy & Phaco
Combining phacoemulsification with ab-interno canaloplasty and trabeculotomy offers an elegant, blebless approach to simultaneously treating cataracts and glaucoma. This triple procedure targets the eye’s natural outflow pathway without requiring a permanent scleral implant. Under gonioscopic visualization, a specialized microcatheter is inserted through a clear corneal incision, passed across the anterior chamber, and cannulated into Schlemm’s canal. The image highlights the device positioned and ready to advance through the canal for 360 degrees. As the catheter is retracted, a viscoelastic material is injected to dilate the canal and open the collector channels (canaloplasty). The meshwork is then cleaved (trabeculotomy) to eliminate the primary source of outflow resistance. This comprehensive approach maximizes intraocular pressure reduction while utilizing the standard phaco incisions, offering an efficient, minimally invasive profile that preserves conjunctival tissue for any necessary future interventions. Just keep in mind that these specialized disposable devices cost $2000 to $4000 US dollars each, compared to $300 to $400 for a specialized blade, or $20 for a polypropylene suture for GATT, or $1 for a needle for BANG.
