{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:12:30Z","timestamp":1783987950783,"version":"3.55.0"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,12,6]],"date-time":"2019-12-06T00:00:00Z","timestamp":1575590400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To compare a modified incision technique with classic scleral flap dissection for canaloplasty with canal expander regarding efficacy and safety.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a prospective randomized pilot study of 32 eyes of 16 patients with primary open\u2010angle glaucoma, access to Schlemm's canal was created by deep lamellar dissection (scleral flap excision, group 1) or by vertical cut\u2010down incision (group 2). Following canal opening and viscodilation with microcannula and sodium hyaluronate, two Stegmann Canal Expanders were implanted, and the scleral flap or vertical incision, respectively, was closed watertight.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean preoperative intraocular pressure (<jats:styled-content style=\"fixed-case\">IOP<\/jats:styled-content>) was 34.9\u00a0mmHg\u00a0\u00b1\u00a06.7 [standard deviation (<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>)] in group 1 and 33.8\u00a0mmHg\u00a0\u00b1\u00a07.7 (<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>) in group 2 (p\u00a0=\u00a00.66); mean postoperative <jats:styled-content style=\"fixed-case\">IOP<\/jats:styled-content> without medications was 14.3\u00a0mmHg\u00a0\u00b1\u00a02.9 (<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>) in group 1 and 14.8\u00a0mmHg\u00a0\u00b1\u00a05.2 (<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>) in group 2 at 1\u00a0month (p\u00a0=\u00a00.76), and 14.4\u00a0mmHg\u00a0\u00b1\u00a01.9 (<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>) in group 1 and 16.8\u00a0mmHg\u00a0\u00b1\u00a03.1 (<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>) in group 2 at 12\u00a0months (p\u00a0=\u00a00.01). Overall, there was a significant preoperative\u2013postoperative <jats:styled-content style=\"fixed-case\">IOP<\/jats:styled-content> difference between groups (19.4\u00a0mmHg\u00a0\u00b1\u00a010.1, group 1; 16.6\u00a0mmHg\u00a0\u00b1\u00a08.9, group 2; p\u00a0=\u00a00.02). Surgery type had a significant effect when adjusted for preoperative <jats:styled-content style=\"fixed-case\">IOP<\/jats:styled-content>, cup\u2013disc ratio, eye side, follow\u2010up number and surgery type (p\u00a0&lt;\u00a00.01, <jats:sc>anova<\/jats:sc>). No filtering bleb was observed in either group. Intra\u2010 and postoperative complications were rare and included peripheral Descemet's membrane detachment (3), microhyphema (2) and cannulation into the anterior chamber (1).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this intra\u2010individual comparative study of ab externo canaloplasty with the canal expander, <jats:styled-content style=\"fixed-case\">IOP<\/jats:styled-content> reduction was substantial in both groups and slightly greater in the group with deep scleral flap excision. Additional <jats:styled-content style=\"fixed-case\">IOP<\/jats:styled-content> reduction by transscleral drainage through the Descemet's membrane window and intrascleral lake is suggested.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.14323","type":"journal-article","created":{"date-parts":[[2019,12,6]],"date-time":"2019-12-06T09:08:01Z","timestamp":1575623281000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Access to Schlemm's canal for canaloplasty: an intra\u2010individual comparison of two dissection techniques"],"prefix":"10.1111","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0612-4309","authenticated-orcid":false,"given":"Matthias C.","family":"Grieshaber","sequence":"first","affiliation":[{"name":"Department of Ophthalmology Sefako Makgatho Health Sciences University (formerly Medical University of Southern Africa), Medunsa Pretoria South Africa"},{"name":"Department of Ophthalmology 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