Restoring aqueous flow in early glaucoma

Chicago-Robert Stegmann, MD, has spent years working on a procedure to reverse glaucoma. He demonstrated the results of canaloplasty to reinstitute aqueous flow in eyes with no flow and severely high IOP values. Dr. Stegmann, professor and chairman, Medical University of South Africa, Pretoria, delivered the Stephen A. Obstbaum, MD, Honored Lecture, titled “The Time Has Come, the Walrus Said . . . to Cure Glaucoma.”

Dr. Stegmann demonstrated in detail his technique that uses a canal expander to restore normal physiologic function to the entire length of Schlemm’s canal in eyes with early glaucoma. Extensive follow-up has shown that with restitution of the physiological function, normalization of the cup is realized.

In many of his cases, the IOP levels were in the 30s and following surgery normalized to from 9 to 12 mm Hg.  He showed cases in which after 15 or 21 years of follow-up, the cupping has not increased and the IOPs have remained low.

“Early intervention can turn the disease around completely,” Dr. Stegmann said. “Operate early. Determine the diagnosis. If you can visualize two collector channels, you can achieve IOPs of 9 to 12 mm Hg. If you find only one, you can achieve 18 mm Hg. The earlier you operate the better are the chances of finding two.”

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