Mechanism of Action
Canaloplasty works by restoring the natural outflow pathways for aqueous humor in glaucoma patients, using a technique similar to angioplasty. Performed with the iTrack™ microcatheter, Canaloplasty addresses all possible sites of outflow resistance, including Schlemm’s canal, the trabecular meshwork and the distal outflow system, beginning with the collector channels. During the procedure, Schlemm’s canal is dilated over 360 degrees to more than 250 microns in diameter, which helps to pop open previously obstructed collector channel ostia.
Ab Externo Procedure
In the ab externo Canaloplasty procedure, the iTrack™ microcatheter is inserted into Schlemm’s canal under a scleral flap. Next, the microcatheter delivers viscoelastic to increase the flow through the trabecular meshwork by causing micro perforations that enlarge the canal and dilate the collector channels. Following this, a tensioning suture is tied in situ in Schlemm’s canal to ensure the canal stays open and to further stretch the trabecular meshwork. A Descemet’s window allows percolation of aqueous into the scleral lake formed by the deep sclerectomy incision, providing a further reduction of IOP.
Ab Interno Procedure
ABiC™ is performed via a self-sealing, clear corneal incision and offers the clinically proven benefits of 360° viscodilation of Schlemm’s canal provided by traditional Canaloplasty but via a simplified and much faster surgical approach. Specifically, the precisely controlled delivery of Healon/Healon GV during withdrawal of the iTrack™ microcatheter separates the compressed tissue planes of the trabecular meshwork, and also triggers the withdrawal of any herniated inner wall tissue from the collector channels. Eschewing the suture employed in traditional Canaloplasty, along with the creation of a scleral lake and Descemet’s window, dramatically reduces the overall surgery time: on average, ABiC™ can be performed in just five minutes.