Canaloplastie ab interno (ABiC) – l’alternative peu invasive à la chirurgie du glaucome
Prof. Dr méd. Maya Müller sur ABiC avec le iTrack d’Ellex.
04/2019
In accordance with the ethical guidelines of SWISS MEDTECH and FMH, no monetary benefits were promised to the interview partner for this report.
„I have been performing glaucoma surgery for almost 20 years, including successful trabeculectomy. I have not carried out trabeculectomy since I started performing canaloplasty 10 years ago. I prefer canaloplasty for all my patients with primary and secondary open angle glaucoma. Both ab-interno as well as ab-externo canaloplasty are excellent procedures for glaucoma surgery. For me, ab-interno is the surgical method where you might expect a little less pressure reduction. However, this does not apply to all cases. It has been proven that even with high initial pressure situations a significant reduction is achieved. The cataract surgeon can use the ABiC as an add-on procedure. With the ab-interno method, the patient has the best option of minimally invasive glaucoma surgery, such as no implants and an extension of all natural drainage pathways. All options for further glaucoma interventions are still available, if at all necessary. The learning curve concerns intraoperative gonioscopy, lens handling and catheter manipulation, which can easily be learned. Post-operative management in ab-interno canaloplasty is simple because it is the standard procedure, especially in combination with cataract surgery. Of course, it is important to be aware of potential steroid responses after 2 weeks which does not mean that the surgery failed, but that the steroids should be discontinued. I would advise an ab-interno beginner to get intraoperative training and to master the handling of the gonioscope. Good adjustment of gonioscope and microscope is key as it facilitates visualization. This, together with previous teaching, allows early surgical success. I use ab-externo canaloplasty for other forms of glaucoma, such as pigment dispersion or PEX glaucoma, even if synechiae are present. In these cases, a 360° trabeculotomy is an additional surgical option.”
Prof. Dr méd. Maya Müller
Médecin en chef de l'ophtalmologie
Vous obtiendrez des informations supplémentaires concernant ABiC avec iTrack sur le site internet de Mediconsult AG.