case_images: PMC11182096_01
case_images: The left eye is treated with penetrating keratoplasty for keratoconus with severe corneal residual scarring after prior resolved corneal hydrops (A) and has a peripheral cornea opacification (arrows) (B). The angle (arrow) cannot be detected through a surgical gonioprism lens (C).
case_images: fopht-03-1226316-g001.jpg
case_images: PMC11182096_01_fopht-03-1226316-g001.jpg
case_images: f1
case_images: The steroid therapy has made corneal opacity improve, but the peripheral corneal opacity and neovascularization have been worsening. ( Figures 1A, B ). Therefore, we could not detect the angle through a surgical gonioprism lens ( Figure 1C ).
case_images: We developed the 23-gauge gonio-endoscope, which is bent 25 degrees and has a focus distance of 5 mm (A). The gonio-endoscope facilitates clear visualization of the trabecular meshwork (arrow) (B). We performed muLOT using the Matsushita ed. TMH (black dotted arrow) and gonio-endoscope (black arrow) and incised the trabecular meshwork nasally by 180 degrees (C).
case_images: fopht-03-1226316-g002.jpg
case_images: PMC11182096_01_fopht-03-1226316-g002.jpg
case_images: f2
case_images: We developed a new 23-gauge gonio-endoscope (MACHIDA Endoscope Co., Ltd., Chiba, Japan and NIPRO CORPORATION, Osaka, Japan) with a light-emitting diode (LED) light source, the probe of which is bent 25 degrees and those focal length is 5 mm to help clear visualization of and access to the trabecular meshwork ( Figures 2A, B ), although the focal distance of currently used endoscope is 2 or 5 mm. Technology, Rayleigh, UK, and ME Technica, Tokyo, Japan) into each side port ( Figure 2C ). The intra-anterior chamber maneuvers were performed through a surgical microscope. The anterior chamber angle was visualized through the gonio-endoscope and the trabecular meshwork was incised nasally at 180 degrees.