The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on canaloplasty for primary open-angle glaucoma.


Primary open angle glaucoma is a condition associated with a long-term increase of pressure within the eye. It may gradually lead to permanent loss of sight because of damage to the nerve that connects the eye to the brain (optic nerve), which is essential for sight. Canaloplasty involves widening the main drainage canal in the eye to help prevent the build up of fluid. The drainage canal is situated within the angle between the iris (the coloured part of the eye) and cornea (the transparent outer coating of the eye). A tiny tube is inserted into the canal and a thick fluid (viscoelastic) is injected to open it up. The tube is then removed and a stitch is placed within the canal to keep it open. The aim is to restore the eye's natural drainage system and reduce pressure within the eye.

Coding recommendations

C60.6 Viscocanulostomy

Y53.2 Approach to organ under ultrasonic control

In addition the ICD-10 code H40.1 Primary open-angle glaucoma would be recorded.

Your responsibility

This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account. However, the guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.

Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.