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Non-penetrating glaucoma surgery (NPGS) is selectively used on the altered structures responsible for ocular hypertension. It is performed without penetrating the eye bulb; and different to other widely-used techniques, it is essentially extraocular surgery. In this way, the surgeon avoids the possible complications associated with penetrating surgery, such as trabeculectomy, still considered to be the gold-standard in the surgical treatment of open-angle glaucoma. In primary open-angle glaucoma and in some cases of secondary glaucoma, resistance to drainage of the aqueous humor is principally produced by the juxtacanalicular trabeculate and the internal wall of the Schlemm’s canal: these are the two target structures of NPGS. The choice regarding which procedure to use in a patient affected by glaucoma must be taken on a case by case basis and it is extremely difficult to propose a standard treatment protocol. There are three types of procedure that are included in this group: viscocanalostomy, sclerectomy and more recently, canaloplasty. Canaloplasty is the procedure that in recent times is receiving greater consensus among the specialists of glaucoma surgery. And increasingly, this type of surgery is performed in combination with the cataract procedure (phacoemulsification). |
