Dear Dr Richardson, I’m a 38 year old from Malta (Europe) and I discovered I had glaucoma in [month hidden] 2013. I’ve had two visual field tests and most recent one shows no further deterioration. It seems my right eye is normal but there is some deterioration in the left eye. I am seriously worried as my doctor, who is very good, doubtlessly, has to keep increasing my drops because despite the fact that they are always effective to start with, after some time they stop working, which I understand is because my eye is producing more fluid, or the drainage system is getting blocked further. The pressure was 27 when I first discovered it, and it immediately when down to 18 with the Beta blocker (Timolol) but after a few months it was up to 24 so I started taking a second type of drop which worked at first but now it is back to 24. I’m now trying a new product, which is a mixture of these two – Cosopt – but if this does not work I’ll have to opt for an operation as I am very reluctant to use the third kind of medication (Travatan) since it would change my eye colour to dark brown.
I asked my doctor about laser surgery. I read about it but it seems that it only lasts for a maximum of two years and that it is usually followed by the other more traditional operation. My doctor also seems to think that the short term laser surgery might reduce the success rate of the operation that would follow it. I’d like to know whether this is true.
It seems to me therefore, that Canoloplasty would be ideal for me because it would allow me to keep using my lenses. It would be extremely kind if I could have a very objective brief on risks, side-effects and rate of success. I am in Malta and can’t travel to the States there and then. I’ll wait for another 6 weeks to see whether the new drops work, but in the sad eventuality that my glaucoma is still not under control, I’ll have to be operated. I apologize for taking your time and I look forward to a reply.
Assuming that your angles are open, it does appear that you may be a good candidate for canaloplasty. I’ve outlined the risks of surgery in detail in my “Canaloplasty FAQ” booklet”
With regard to your question about laser surgery, it is true that Argon Laser Trabeculoplasty may decrease the likelihood of success with canaloplasty. This is less of a concern with Selective Laser Trabeculoplasty. If you have additional questions that are not answered in my FAQ eBook feel free to email them to me. I’ll be happy to further clarify.
David Richardson, MD
Date: Apr 17, 2014