Canaloplasty is an advanced surgical treatment for glaucoma and uses breakthrough microcatheter technology to enlarge your eye’s natural drainage system, similar to angioplasty. Unlike traditional glaucoma surgery, which bypasses the eye’s natural drainage channels, Canaloplasty is a restorative procedure that restores the natural outflow pathways in order to reduce elevated intraocular pressure (IOP). It is a “non-penetrating” glaucoma surgery that does not require the creation of a permanent hole in the eye, so does not result in a “bleb” (blister). Canaloplasty has an excellent safety profile with minimal post-operative follow-up and faster recovery time.
What happens during the procedure?
Unlike traditional glaucoma surgeries (trabeculectomy and tube shunts), which bypass the natural outflow system, Canaloplasty works by restoring the natural ocular outflow function in four key steps:
The trabecular meshwork is more permeable due to microperforations caused by injection of viscoelastic and and it is stretched by a circumferential suture which holds the meshwork open to allow the fluid to pass through.
The canal into which the fluid drains, known as Schlemm’s canal, is dilated by injection of a visco-elastic substance so that the flow is enhanced.
The dilation of the canal also opens up the collector channels which transport the fluid into the circulation system.
An additional fluid reservoir is created within the ocular wall. This reservoir can be stimulated to release more fluid if necessary in the longer term.
What are the side effects of Canaloplasty?
One of the key advantages of Canaloplasty is its high safety profile. It is associated with significantly fewer risks, both in number and severity, than traditional glaucoma surgeries. It is important to note, however, that all surgeries have risks associated with them.
The most common risks of Canaloplasty are:
- Bleeding in the Eye
- Intraocular Pressure “Spikes”
- The Formation of a Bleb
- Descemet’s Membrane Separation
- Hypotony (IOP too low)
Does Canaloplasty hurt?
No. During the surgery your eye will be anesthetized. Post-surgery your surgeon will prescribe eye drops to reduce inflammation and to prevent pain.
Who will benefit from Canaloplasty?
It is necessary to first undergo an ophthalmic examination in order to determine your eligibility for Canaloplasty. Canaloplasty is indicated for the reduction of elevated IOP in open-angle glaucoma (OAG) patients, including pigmentary glaucoma (PG), pseudoexfoliation glaucoma (PXF), normal tension glaucoma (NTG) and juvenile glaucoma. While it can be performed across the entire glaucoma treatment spectrum, it is particularly well suited to patients who have difficulty administering eye drops, or for whom medications or laser treatment are no longer effective. It is also a good option for patients who are reluctant to undergo the more invasive trabeculectomy surgery, which is often reserved for the end-stage of the disease. Trabeculectomy can 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.
What if Canaloplasty doesn’t work for me?
A key benefit of Canaloplasty is that is does not preclude any other form of glaucoma treatment. If the procedure is not successful, your surgeon may elect to perform laser-based treatment, such as SLT, or conventional glaucoma surgery (trabeculectomy). Medication may also be an option.