Fig. 1

Intraoperative images of endoscope-assisted transluminal trabeculotomy. a Surgery was performed on the patient’s temporal side. b A microsurgical goniotomy incision was made using a vitreoretinal blade under endoscopic imaging guidance (arrow, Schlemm’s canal; arrowhead, microsurgical blade). The blade was inserted at the 3 o’clock position of the right eye. c The suture was inserted into Schlemm’s canal using microforceps. Negligible bleeding was observed during insertion of the suture. The following operation was performed by inserting the suture counterclockwise from the position of 3 o’clock of the right eye. d The insertion point of the suture into Schlemm’s canal on the circumference side was confirmed on the basis of changes in the location of the endoscope tip. e The trabeculotomy incision was made by pulling the suture while using blood that had refluxed from the goniotomy incision slot as a fulcrum. f The surgeon performed most of the surgery with the patient in a head-up position and used a monitor for observation