Needling, also known as non-penetrating needle trabeculotomy or needle viscocanalostomy, is a medical procedure used in the treatment of glaucoma. It is mainly applied in patients who have experienced an increase in intraocular pressure (IOP) after a previous glaucoma surgery, such as trabeculectomy or non-penetrating deep sclerectomy.
After glaucoma surgery, a new drainage channel for the aqueous humor, the fluid that fills the eye, is created. However, over time, this channel can become blocked by scar tissue, leading to an increase in IOP. Needling aims to break down this scar tissue and restore the normal flow of aqueous humor, thereby reducing eye pressure.
What does the procedure involve?
Needling can be performed in the doctor’s office or in the operating room. The procedure is quick and painless, as topical anesthesia is used. The ophthalmologist inserts a thin needle under the conjunctiva, the transparent membrane covering the white part of the eye. The bevel of the needle is then used to break the scar tissue obstructing the drainage channel.
What are the benefits of needling?
Needling offers several benefits for patients with glaucoma who experience increased IOP after surgery:
- Reduces intraocular pressure: Breaking the scar tissue allows the aqueous humor to drain freely, thereby reducing eye pressure and the risk of optic nerve damage.
- Quick and painless procedure: Needling is performed quickly with topical anesthesia, minimizing discomfort for the patient.
- Outpatient procedure: It does not require hospitalization, allowing the patient to return home on the same day as the procedure.
- Effective in refractory glaucoma cases: Needling can be an effective option for patients with glaucoma who do not respond to medical treatments or other surgical procedures.
