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Indocyanine Green Aided Schlemm Canal Identification During Gonioscopic Assisted Transluminal Trabeculotomy

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Performing procedures like gonioscopic assisted transluminal trabeculotomy in eyes with congenital glaucoma may be difficult many a times due to difficult visualization of angle structures. Inaccurate identification of the angle… Click to show full abstract

Performing procedures like gonioscopic assisted transluminal trabeculotomy in eyes with congenital glaucoma may be difficult many a times due to difficult visualization of angle structures. Inaccurate identification of the angle landmark may lead to various inadvertent surgical complications. Hence, there is a need for techniques to improve visualization of surgical landmarks during these procedures. In this study, 0.2% indocyanine green was used to stain the trabecular meshwork before the surgeon proceeded with gonioscopic assisted transluminal trabeculotomy. It yielded excellent differentiation of the trabecular meshwork by imparting a bright green hue. This led to successful identification of the site of incision and subsequent 360 degrees cannulation of Schlemm canal in 5/5 cases. Indocyanine green aided Schlemm canal identification is helpful in children with congenital glaucoma undergoing angle surgeries, especially in eyes with poor structure differentiation.

Keywords: transluminal trabeculotomy; indocyanine green; gonioscopic assisted; assisted transluminal; identification; schlemm canal

Journal Title: Journal of Glaucoma
Year Published: 2022

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