Non-Penetrating Deep Sclerectomy with Canalectomy

Rafael Bohorquez, MD, begins the case by making a fornix-based conjunctival incision followed by a superficial scleral flap. Mitomycin C is applied for 3 minutes, after which the deep scleral tissue overlying Schlemm's canal is excised. Blunt Utrata forceps are used during the canalectomy to peel away the inner wall and endothelium of Schlemm´s canal and the juxtacanalicular trabeculum. Viscoelastic is left in the scleral bed as a space-maintainer. To complete the case, the superficial flap is left sutureless and the conjunctiva is secured with one to two 10/0 nylon sutures.

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Comments (13)

great and helpfull video Dr. Qaher from Afghanistan Kabul

Popal (29 months ago)

great and helpfull video Dr. Qaher from Afghanistan Kabul

Popal (29 months ago)

Dear Martin Pillichshammer: I have already though something like that but with the superficial flap to leave a bigger space but i have not do it because i though it could make a mass and the conjunctival suture could be not tight or make a sensation of mass for the patient. Your technique is interesting with the deeper flap, however i think that leave the deeper flap make a lot of chance to close the drainage zone with time. But i would like to know your experience in success rate with your technique. Thanks a lot

Rafael (63 months ago)

Dear Rafael Bohorquez

Martin Pilli (64 months ago)

great video thanks

drserkand4 (65 months ago)

To dilate the canal is an option that I think could improve the success rate (already as a surgery combinated with a viscocanalostomy), I didnt do it yet, but we should consider too the excesive manipulation could break the trabeculodescement membrane.

Rafael (68 months ago)

that is realy nice but forgive me Dr Bohorquez would it be more safer if we dilate the canal ? and secondly what is the success rate in black hyper pigmented patients ?

Abo basil (69 months ago)

The relative success rate (under 21mm Hg) was 95% in a year, and absolute success rate was 59% (under 16 mm Hg). All patients were POAG without previous surgery.

Rafael (69 months ago)

good video . what is succees rate .

dr devendra (69 months ago)

I used viscoat in the procedure but now we have more dense viscoelastics so it is possible to use it because we need the most time as possible in scleral bed to avoid colapse of the space. I dont think we could put there amniotic membrane because probably it could block the area of filtration and wont function as space maintainer.

Rafael (69 months ago)

which viscoelastic was used as a space-mainainer?

DIPANJAN PAL (69 months ago)

very good Dr. Bohorquez

andres (71 months ago)

great video Dr. Bohorquez!

ZMario (71 months ago)