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The National Institute for Health and Care Excellence (NICE) issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Canaloplasty for primary open angle glaucoma in May 2008. NICE is currently updating this guidance. The new guidance will be published shortly. Until then the NHS should continue to follow the recommendations outlined in the current version of the guidance. The Interventional Procedures Advisory Committee (IPAC) will consider this procedure review and NICE will issue an interventional procedures consultation document about its safety and efficacy for 4 weeks’ public consultation. IPAC will then review the consultation document in the light of comments received and produce a final interventional procedures document, which will be considered by NICE before guidance is issued to the NHS in England, Wales, Scotland and Northern Ireland.
 
Status In progress
Process IP
Description Ab externo canaloplasty is a surgical technique that aims to reduce intraocular pressure, by improving drainage of aqueous fluid from the eye. It is done under local or general anaesthetic. A superficial hinged flap of sclera is made and a deeper flap excised, exposing the Schlemm's canal. An ultrasound imaging system is used to identify the canal and to visualise the surgical instruments when they are in the canal. A microcatheter with an illuminated tip is introduced into the canal and advanced around its entire circumference. As the catheter tip advances, viscoelastic fluid is injected into the canal to dilate it. When catheterisation of the entire canal is complete a suture is tied to the tip of the microcatheter and it is withdrawn, pulling the suture into the canal. The suture is cut, tied in a loop encircling the inner wall of the canal and tightened. This widens the canal. The superficial flap is sutured.

Timeline

Key events during the development of the guidance:

Date Update
26 May 2017 - 23 June 2017 Interventional procedure consultation

For further information on how we develop guidance, please see our page about NICE interventional procedures guidance