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Dye allows visualization of aqueous flow pathway after canaloplasty
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Indocyanine green-stained viscoelastic injected into Schlemm’s canal during canaloplasty enables surgeons to visualize the entire aqueous humor outflow pathway.
“We were able to see the aqueous humor filtering through the 360° dilated Schlemm’s canal and then through the collector channels. Even the knots of the Prolene suture were clearly visible due to indocyanine green impregnation,” Michele Fortunato, MD, said in an interview with Ocular Surgery News.
Michele Fortunato
The indocyanine green (ICG) canaloplasty procedure was performed by Fortunato and his colleague Lucio Zeppa, MD, in 20 patients. Each case was monitored with ICG angiography techniques at 2, 4, 8, 12, 24, 36 and 48 hours to follow the hydrodynamic phases of the aqueous humor.
“Quite surprisingly, in the first hours we were able to detect a distinct leakage of the pupillary margin, lasting for about 24 hours. We speculated that this might be the sign of a still unknown retrograde drainage system that involves the iris and pupillary margin,” Fortunato said.
Further studies are under way to confirm these findings.
“ICG monitoring of aqueous circulation may be a useful technique not only after glaucoma surgery but also intraoperatively to assess Schlemm’s canal opening and outflow facility over its entire length,” Fortunato said.
Disclosures: Fortunato and Zeppa have no relevant financial disclosures.