Canaloplasty, the New Surgical Treatment for Glaucoma
Glaucoma is a scary condition because so many people know someone who lost eyesight from it. Medications can control eye pressure and prevent vision loss in some people for a long time, but when it can't, surgery is the only treatment available. Laser surgery (ALT, SLT)) works well for some people but may not last forever and can make glaucoma worse in others. When it isn't able to control your pressure, the alternatives become limited.
One of the safest, effective techniques for controlling Open Angle Glaucoma is Canaloplasty. This procedure uses the natural drainage channel of your eye to lower the pressure by stretching the meshwork filter. It is this tissue filter that limits the flow of fluid making the pressure too high and causing vision loss.
Why Canaloplasty is safer than some alternatives.
Trabeculectomy, or Glaucoma Filtering Surgery has been used for more than 100 years to surgically treat glaucoma. During this procedure, a hole is created in the white part of the eye (sclera) at the edge of your cornea and the eye fluid is then rerouted into the space under the skin that covers your eyeball (conjunctiva). This produces a bubble (bleb) where the fluid comes out and because this lifts up that skin layer it is difficult to wear a contact lens on your eye after surgery.
When you make a new hole in any tissue, your body tries to heal or scar it shut. Trabeculectomy will fail to control your glaucoma if this happens, so surgeons use chemicals that prevent scarring or use plastic tubes to keep the hole open. There are potentially serious risks involved with the use of these chemicals and plastic tubes. There is lots of follow-up visits and you must limit your activities for a while after Trabeculectomy and that can be a problem for some people.
Consequently, we have worked hard to find new surgical methods that would offer both patient and doctor a better way to surgically treat glaucoma.
Non-Penetrating is best
Canaloplasty is Non-Penetrating eye surgery, meaning that the surgery does not go into your eye, but just works on the surface tissues. This Non-Penetrating approach does not create a full-thickness hole into the anterior chamber, as with trabeculectomy. Instead, the eye fluid flow through the natural drainage channels begins as slow percolation, which prevents a potentially dangerous rapid drop of eye pressure. This gives Canaloplasty an excellent safety profile, with early eye pressure stability after surgery and quick recovery time. It also means less activity restrictions and post-op visits for you.
How do we do it?
Canaloplasty is performed with a local anesthetic so you don't feel anything when the surgery is performed and most people don't even need a pain pill after surgery because it just doesn't hurt. We perform the surgery on the upper white part of the eye (sclera) under your upper eyelid so you don't see the area where the surgery was performed when someone looks at your eye. We make a small flap in the tissue, much like the flaps that we make with LASIK surgery, and under that flap we locate the opening of the natural drainage channel for the fluid in your eye (Aqueous Canal). We then feed a very tiny fiberoptic probe all the way around the eye through this channel. Through the probe, we fill the channel with a jelly, and feed a fine suture into the channel as the probe is removed. When this suture is tied, it stretches the filtration tissue (Trabecular) meshwork to ease the flow of eye fluid into this natural channel. We then stitch the flap closed to seal it back in place.
What can I expect on the day of surgery?
Your Canaloplasty is performed in an Ambulatory Surgery Center so there is no need to go to a hospital. You should not eat or drink for 8 hours prior to surgery to leave your stomach empty. If you take regular medications, we will tell you how and when to take them on the day of surgery. Your eye will not need dilating eye drops. We will place an IV on the the back of your hand and give you relaxing medications before starting your procedure. While you are snoozing for a few minutes, we will give the local anesthetic that numbs and freezes your eye so nothing will hurt. You can relax and listen to music for the 40 minutes it takes to complete your procedure. A patch will cover your eye for the rest of he day for protection when your eye is fresh from surgery. You can go home and relax for the rest of the day. For the first week after surgery we don't want you to do any strenuous activity that would cause you to squeeze your eye like heavy lifting. We want you to keep your head above your heart so the blood doesn't rush up to your eye and pop a blood vessel when fresh from surgery. Other than that, you can be right back to most daily activities as soon as you want. We won't want you to drive on the day of surgery because of the relaxing medication, but other than that, there are very few limitations.
And afterwards?
The nice thing about Canaloplasty is the way things should go afterwards. We remove the patch and check your eye the next day. Your vision should be back to normal, though some people will need a small change in their glasses to get the best vision back if there is a focusing shift after surgery. There will be some antibiotic eye drops to use for several days, and gradually as your eye pressure comes down from the surgery, we will be reducing your glaucoma eye drops to where we hope you will no longer need most or all of them. You can bend and lift and be your normal active self from after the first week on, though we won't want you swimming with your head under water for at least a month. That how easily we expect this to go!
For more information on canaloplasty or to schedule an appointment, contact our office at 877-718-2020 or click here to email us.
612 North New Ballas Road
Saint Louis, MO 63141 PH: 314.863.9966 | 877.718.2020 | FAX: 314.863.9977 EMAIL:info@surevision.us
Find us in the Saint Louis, Hazelwood, Alton, Maryville,
St. Charles, Creve Coeur and Granite City areas.
