Abstract:

The original concept of Cairns' trabeculectomy in 1968 was to expect that aqueous humor flowed into the Schlemm’s canal through the trabeculectomy which achieved the internal drainage to reduce intraocular pressure (IOP). Yet, studies found that even the most successful patients have obvious filtering blebs, and trabeculectomy was subsequently identified as an external drainage filtration surgery. After 50 years of improvement, trabeculectomy supplemented by antimetabolites and releasable sutures has become an almost perfect surgery, and is the leading surgery for treating glaucoma. However, bleb scarring remains a huge challenge for controlling long-term IOP. In order to reduce complication rates, some scholars have turned their attention to non-penetrating glaucoma surgical techniques, but postoperative effect is limited. Recently, minimally invasive glaucoma surgery (MIGS) has demonstrated low postoperative complication rates, but the effectiveness of IOP control is also limited and ranges of operative indications are narrow. We integrate the canaloplasty into trabeculectomy, converting trabeculectomy to an "internal drainage" surgical procedure to avoid bleb scarring, an unbeatable natural healing response.

Key words: glaucoma/surgery, trabeculectomy, canaloplasty