FAQs / Is it possible to have canaloplasty after cataract operation?

February 7, 2017

QUESTION:

I have glaucoma and also need to have cataract surgery and I understand that these two surgeries are now combined for better effect. I am in Australia but I am looking at coming on a visit to USA to have a consultation with Dr. Richardson to see if I am good candidate for canaloplasty. Canaloplasty is not offered in Australia. I have attached my eye doctor’s notes for you to access.

1. My glaucoma doctor is happy to take care of me following the canaloplasty surgery here in Australia.
2. Is it possible to have canaloplasty after cataract operation? Is the best outcome if both (cataract & canaloplasty) are done at the same time.
3. How many canaloplasty surgeries has Dr. Richardson done and how any of them does he do for a year or a month.
4. Have you achieved 10-14 pressure with any of his patients with canaloplasty and cataract surgery. How realistic is it for me expect this pressure drop in this range. I am OK with achieving this even with drops if I can stay off having trabeculectomy.
5. How long do I have to stay after the canaloplasty operation before I return to Australia.

Can you let me know how I can progress to getting consultation appointment and possible surgery for canaloplasty.

Thanks very much.

via Email

ANSWER:

I’ve had the opportunity to review the letter and test printouts you attached (thank you). From my limited review it does appear that you would be a candidate for canaloplasty. I will address each of your questions below:

1) Is it possible to have canaloplasty after cataract operation? Is the best outcome if both (cataract & canaloplasty) are done at the same time?

It is possible to have canaloplasty after cataract surgery so long as the cataract surgeon has NOT placed an iStent or other “intracanalicular stent” as was suggested in Dr. Okera’s letter. Placement of an iStent or other “intracanalicular stent” is one of the few surgeries after which canaloplasty cannot be done. It would be OK, however, to have endocyclophotocoagulation (ECP) done at the time of cataract surgery if that is available to your local surgeon.

2) How many canaloplasty surgeries has Dr. Richardson done and how any of them does he do for a year or a month?

I have performed over 200 canaloplasty surgeries (possibly 300+ but I stopped counting after 200) and for a while was one of a small group of canaloplasty surgeon instructors. As I no longer participate in insurance or Medicare I am no longer a “high volume” surgeon (which is as I and my patients prefer it). However, I still regularly schedule canaloplasty 1-3 times each month.

3) Have you achieved 10-14 pressure with any of his patients with canaloplasty and cataract surgery? How realistic is it for me expect this pressure drop in this range? I am OK with achieving this even with drops if I can stay off having trabeculectomy.

Yes, that is realistic with anticipated drop use after surgery.

4) How long do I have to stay after the canaloplasty operation before I return to Australia?

I would prefer at least one month though if you heal quickly it might be possible to go back earlier.

Can you let me know how I can progress to getting consultation appointment and possible surgery for canaloplasty.

I have copied my nurse, Ana, on this email so that you may schedule a consultation, anticipated surgery, and travel.

Warm regards,
David Richardson, MD
Patient-Focused Ophthalmologist

San Marino Eye
2020 Huntington Drive
San Marino, CA 91108
626.289.7856

Patient-Focused Websites:
New-Glaucoma-Treatments.com
About-Eyes.com

Posted in: Canaloplasty, Canaloplasty and Other Surgeries, Canaloplasty and Recovery