title: [Trabeculectomy versus canaloplasty].
abstract: BACKGROUND
  Trabeculectomy provides an excellent reduction of intraocular pressure (IOP) and is the reference technique in the treatment of glaucoma patients. Canaloplasty is a relatively new surgical non-penetrating procedure for restoring the natural outflow pathway of aqueous humour. The aim of canaloplasty is to permanently distend the collapsed Schlemm's canal with the placement of a 360° intracanalicular tension suture.
  
  
  OBJECTIVE
  This review article describes the comparison between trabeculectomy and canaloplasty with and without cataract surgery.
  
  
  METHODS
  Original studies, case reports and reviews are described and the results are discussed.
  
  
  RESULTS
  Although canaloplasty may not be as effective in reducing IOP, trabeculectomy can be associated with severe vision-threatening complications however, the combination of canaloplasty with cataract surgery achieves a higher IOP reduction than canaloplasty alone. In contrast, trabeculectomy alone provides better IOP control than phacotrabeculectomy due to a higher risk of early bleb scarring induced by an increased intraocular inflammatory reaction.
  
  
  CONCLUSIONS
  If a higher postoperative IOP is acceptable and additional topical glaucoma medication tolerable, canaloplasty can be considered as an alternative to trabeculectomy as the incidence of complications is low and postoperative care less intensive. Canaloplasty may also be suitable for patients with high risk of bleb failure and early glaucoma with a target IOP not necessarily requiring a filtering procedure. Therefore, canaloplasty offers a treatment option for the management of open-angle glaucoma, especially in combination with cataract surgery.
authors.affiliation: NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, 162 City Road, EC1V 2PD, London, UK, juliane.matlach@moorfields.nhs.uk.
authors.forename: J
authors.initials: J
authors.lastname: Matlach
authors.forename: T
authors.initials: T
authors.lastname: Klink
mesh_terms: D001082:Aqueous Humor / Q000502:physiology*; D005901:Glaucoma / Q000601:surgery*; D005902:Glaucoma, Open-Angle / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D009883:Ophthalmic Solutions / Q000627:therapeutic use; D014130:Trabeculectomy / Q000009:adverse effects / Q000379:methods*
chemical_list: D009883:Ophthalmic Solutions