January 2017 – NICE is updating this guidance (see the guidance in development page for information). The NHS should continue to follow the recommendations in this guidance until the update is complete.

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 and clinical classification codes for this guidance.

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.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.