Rhythmic suture movement on gonioscopy after penetrating canaloplasty: a case report

By
Suju Liu
Zhengfang Wu
Ping Yu
Liuzhi Zeng
June 18, 2026
0 min

Bmc Ophthalmology

Overview

This case study documents a unique gonioscopic finding of rhythmic suture motion in Schlemm’s canal following penetrating canaloplasty. The observation suggests dynamic behavior in the trabecular meshwork–Schlemm’s canal complex, which may have implications for understanding aqueous outflow.

Background

The trabecular meshwork–Schlemm’s canal complex is known to exhibit dynamic changes influenced by intraocular pressure and cardiac rhythms. Understanding these dynamics is crucial for improving surgical techniques aimed at managing glaucoma. This case highlights the potential for routine gonioscopy to reveal significant insights into the behavior of this complex post-surgery.

Data Highlights

No numerical data or trial data available in the article.

Key Findings

Gonioscopy revealed rhythmic movement of a 10 − 0 suture in Schlemm’s canal at 2-year follow-up.
The patient had chronic angle-closure glaucoma and underwent penetrating canaloplasty.
Postoperative IOP was stable at 18 mmHg with improved best-corrected visual acuity.
This case is the first to document dynamic motion in Schlemm’s canal via routine gonioscopy.
The retained suture may serve as a marker of local dynamic behavior in the SC region.

Clinical Implications

The findings suggest that gonioscopy can be a valuable tool for observing dynamic changes in the trabecular meshwork–Schlemm’s canal complex. Clinicians should consider the implications of such findings for postoperative assessments and the management of glaucoma.

Conclusion

This case underscores the potential for gonioscopy to reveal important dynamic behaviors in the aqueous outflow pathway. Further studies may enhance our understanding of these phenomena and their clinical significance.