Techniques in Trabecular Meshwork and Canal Surgery

Trabecular meshwork (TM) and canal surgery have become an increasingly popular surgical option amongst anterior segment surgeons. Depending on the severity and type of glaucoma, anatomical features of the irido-corneal angle, and individual considerations, TM and canal surgery offer a number of advantages over traditional filtering surgery including a higher safety profile, better preservation of the ocular anatomy, faster postoperative recovery time, while still providing intra-ocular pressure (IOP) reduction and potentially minimizing the burden of IOP-lowering medications. This chapter explores the evolution in techniques, materials and indications of angle surgery, with particular emphasis on minimal invasive glaucoma surgery (MIGS) and the latest advancements in ab-interno devices and implant free surgical techniques. Additionally, the authors provide a review of current practice and evidence-based indications.