Two cases of intraoperative anterior chamber angle observation using ophthalmic endoscope in viscocanalostomy.

Purpose: To report endoscopic findings in the anterior chamber angle during injection of viscoelastic material in viscocanalostomy (VCS).

Design: Observational case reports.

Methods: Two cases of primary open-angle glaucoma were treated with VCS and cataract surgery. Immediately before and during injection of viscoelastic material into Schlemm's canal, the anterior chamber angle was observed using an ophthalmic endoscope.

Results: In both cases, we observed viscoelastic material in Schlemm's canal and leakage of viscoelastic material and blood from Schlemm's canal into the anterior chamber away from the injection site of the viscoelastic material. In one case, indocyanine green-stained viscoelastic material was not in Schlemm's canal the day after surgery.

Conclusions: In VCS, Schlemm's canal was filled and was disrupted after viscoelastic material injection. Disruption of the inner wall of Schlemm's canal and juxtacanalicular connective tissues may contribute to the intraocular pressure reduction associated with VCS.