Viscocanalostomy an important option for glaucoma, surgeon says

Robert Stegmann, MD, described his viscocanalostomy technique at the DOC conference.

NUREMBERG, Germany — Restoring the flow of aqueous into Schlemm’s canal has been a successful approach to lowering IOP over the long term in glaucoma patients, Robert Stegmann, MD, told attendees here at the Congress of German Ophthalmic Surgeons.

Dr. Stegmann, the developer of viscocanalostomy, spoke about his results with the technique in South Africa during a seminar on its role in the modern treatment of glaucoma.

Other speakers praised Dr. Stegmann for making the journey from South Africa to share his views on the technique he created 12 years ago and has been teaching ever since.

He said the technique is based on finding blocked outflow channels in the trabecular meshwork and opening up those flow channels into Schlemm’s canal. The technique was developed as an alternative to trabeculectomy.

“One such channel could completely control even the worst case of glaucoma if you could harness that one,” he said. He showed a video of eyes being injected with saline solution. Differences that could be seen between normal eyes and glaucomatous eyes illustrated the importance of opening the ocular channels, Dr. Stegmann said.

“Pathology as well as anatomy has tremendous variation in these cases,” he said.

According to Dr. Stegmann, the incidence of glaucoma in African patients is the highest in the world. He said he is accustomed to treating patients as young as 14 years old.

“At that age, glaucoma is a surgical disease, not a medical disease,” he said.

A common factor in cases he has examined is a collapse of Schlemm’s canal, he said, resulting in low aqueous flow because of “patchy filling” of the canal.

“That is the worst sign of pre-glaucoma,” he said.