Canaloplasty for Glaucoma
What is Canaloplasty
Canaloplasty is an advanced minimally invasive glaucoma treatment. It is a “non-penetrating” glaucoma surgery which means it does not require creation of a hole in the eye (fistula) nor does it result in a “bleb” (blister) as required with the more traditional glaucoma surgery called trabeculectomy (“trab” for short).
Canaloplasty does not create a full-thickness hole into the fluid-filled space inside the eye (anterior chamber), as with trabeculectomy. Instead, the eye fluid flows slowly through the natural drainage channels using a breakthrough microcatheter technology, preventing a rapid and dangerous drop in eye pressure. This gives canaloplasty an excellent safety profile, with early eye pressure stability after surgery and faster recovery time. It also means less activity restrictions and post-operative visits for patients when compared to trabeculectomy.
Essentially, this surgery is like angioplasty for the eye as it uses a catheter to dilate the natural drainage system.
As glaucoma can cause a permanent loss of vision, this procedure can provide patients with glaucoma a “peace of mind” not possible with use of glaucoma drops alone. Canaloplasty can reduce eye pressure by nearly 40%, and most glaucoma patients who have had Canaloplasty can cut their glaucoma drops in half. In some cases, Canaloplasty can even eliminate the need for Glaucoma drops.
Canaloplasty is best indicated for Primary open-angle glaucoma, Pseudoexfoliation glaucoma, and Pigmentary glaucoma. It can also be successfully performed in patients with failed trabeculectomy in which Schlemm’s canal has been left undamaged from previous filtrating surgeries.
How is Canaloplasty Performed?
Canaloplasty uses a micro-catheter to open the eye’s natural drainage system (“Schlemm’s canal”). This canal is then opened using a sterile, gel-like material (“viscoelastic”). The iTrack® micro-catheter is then removed while a suture is threaded through Schlemm’s canal. The suture is then tied down resulting in tension on the the inner wall of the canal – just as you might pull on the strings of a “hoodie” to close the hood over your face. The suture placed in the eye’s drainage canal can keep the canal stretched open for years. Once this canal is opened, the eye’s fluid can exit through a more natural process allowing the pressure in the eye to drop to a more normal level. [Canaloplasty Procedure video starts at 2:50]
- It uses the eye’s natural drainage system
- It is a “non-penetrating” procedure that does not create a permanent fistula in the wall of the eye
- It does not require a bleb (a blister-like fluid collection)
- Provides long-term reduction in IOP (see three year results below)
- Reduces the need for medications to keep the IOP controlled
- Is a good option for those patients who are not yet ready for more trabeculectomy or tube shunts
- Is safer than traditional glaucoma surgeries (Canaloplasty vs Trabeculectomy)
Canaloplasty Is Safer
Studies which compared the results of Canaloplasty vs. trabeculectomy (the traditional glaucoma surgical treatment) showed that Canaloplasty patients experienced fewer side effects and complications compared to those who had trabeculectomy. And patients who had Canaloplasty had better vision than those patients who had trabeculectomy. For those who are candidates for Canaloplasty, it offers greater safety over trabeculectomy with similar benefits.
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It is vital to find a safer, more predictable operation with preferably no complications at all. This is the closest I have ever come to that.
Robert C. Stegmann, M.D.
Canaloplasty Is Effective
Canaloplasty showed very impressive results in the published 3 Year Clinical Study. Below are just some of the highlights.
- The number of medications required to keep the IOP under control was reduced by 53% … this sustained reduction in drops used means that the cost of canaloplasty could easily be paid just with the cost savings from using fewer medications to control IOP.
- The reduction in intraocular pressure (IOP) after canaloplasty was 34% – this was the lowest average IOP!
- The IOP in those patients who underwent Phacocanaloplasty™ was reduced by almost half (42%)!
- 88% of patients achieved IOP control without drops three years after canaloplasty!
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Overall, the pressure results of viscocanalostomy are comparable to those of trabeculectomy without mitomycin…but with a much lower risk of postoperative complications and much less intense care required immediately postop. So far, the results of canaloplasty are even better.
Manfred R. Tetz, M.D.
Canaloplasty is Pro-Active Lifestyle
If you are an energetic person who enjoys such activities as watersports, it is important for you to know that having traditional glaucoma surgery will severely limit your ability to participate in certain sports. No such limitation exists with Canaloplasty. Once healed, patients who have had Canaloplasty are able to return to their previous active lifestyles without restriction or limitation.
In comparison with trabeculectomy, postoperative follow-ups tend to be simplified, less stringent, and fewer, which may render canaloplasty more cost-effective in the long run.
Paolo Brusini, M.D.
Canaloplasty Is Preferred by Some of the World’s Most Respected Eye Surgeons
Canaloplasty is a desirable option for glaucoma patients because it decreases the number of necessary post-operative visits and there are fewer complications to treat. As an added bonus, patients save thousands of dollars in the cost of medications because canaloplasty reduces the amount of medication patients need in order to control the IOP. The ultimate result? A happier patient who can go back to enjoying life without restrictions.
David Richardson, M.D.
So I checked around and canaloplasty came up…(Duke Eye Center) mentioned canaloplasty. And I called up another friend of mine who is a chair of UC Irvine and he recommended the same thing….
Robert M. Sinskey, MD
April 20, 2012 | Chicago, IL – Dr. Robert Sinkey is interviewed by Dr. David Richardson at an iScience didactic course during the American Society of Cataract and Refractive Surgery (ASCRS) 2012 annual meeting. Dr. Sinskey discusses his glaucoma diagnosis, treatment and decision to have Canaloplasty as well as the subsequent outcomes of the procedure.
Canaloplasty Has Helped Many Glaucoma Patients
These are just 3 testimonials out of over 30,000 canaloplasty procedures done worldwide!
So I said, “Well we know about me, I don’t like drops, I don’t do them well, laser didn’t work. Can we go right to canaloplasty on the left eye?” And that’s exactly what we did. All in all it was absolutely the right decision, for me. Given who I was, my lifestyle, the way I work, and what I wanted. So it’s an excellent result…It was absolutely the right decision.
My first expression when it was over was that “It was a piece of cake!” And I would recommend it to people because I think it was very successful and the biggest part about it, aside from not losing anymore eyesight, I don’t have to take drops four and five times a day. Four and five drops, four and five times a day. So I was very happy with that outcome also.
There are a lot of costs involved when it comes to travelling all the way from India and then coming here. But seeing the plus points in terms of …physical activities… And seeing that I don’t have to undergo lifestyle modification it’s (cost) hardly anything. And I don’t regret the decision of coming here and getting the surgery done – at all.I’m truly very happy.