The eye’s aqueous fluid is constantly produced and drained at a balanced rate to ensure the health of the lens and cornea. When this drainage becomes blocked, or there is an increase in aqueous fluid production, intraocular pressure increases and glaucoma occurs. Over time, this increase in pressure can cause damage to some of the sensitive structures that receive and transmit images in the eye, including the optic nerve.
The pressure damage of glaucoma causes a gradual blurring of vision and, if left untreated, can result in total, irreversible blindness.
Initially, someone suffering from glaucoma may notice a gradual loss of peripheral (side) vision, before progressing to a complete loss of peripheral vision so that only a small area of central vision remains. Because there are no symptoms associated with the disease in its early stages, regular eye examinations with your ophthalmologist or optometrist are important.
Although risk factors for glaucoma include heredity, diet, smoking and age, the actual cause is often unclear. Raised intraocular pressure, or intraocular pressure within the “normal” range associated with other symptoms, compounds damage caused by poor blood supply, structural weakness and disordered enzyme systems. In all cases, the resulting damage is death of retinal nerve cells and irreversible loss of vision.
There are several forms of glaucoma, including primary open-angle glaucoma, primary closed-angle glaucoma, and normal tension glaucoma. The most common form is primary open-angle glaucoma.
Primary Open-Angle Glaucoma
Primary open-angle glaucoma, the eye’s drainage system – called the trabecular meshwork becomes blocked, creating a slow rise in intraocular pressure that puts pressure on optic nerve fibers.
Variants of primary open-angle glaucoma include “normal tension” glaucoma (NTG), which exists in eyes that do not tolerate seemingly normal pressure, and ocular hypertension, a condition in which intraocular pressure is high without the loss of peripheral vision.
Canaloplasty – A minimally invasive maximally effective treatment option
Canaloplasty is an advanced surgical treatment for glaucoma. It uses breakthrough microcatheter technology to enlarge your eye’s natural drainage system, similar to angioplasty. Canaloplasty is a restorative treatment. Unlike trabeculectomy, which bypasses the eye’s natural drainage channels, Canaloplasty 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.
As an added benefit, Canaloplasty can be performed at any stage in the glaucoma treatment paradigm and can be used in conjunction with existing drug based glaucoma treatments, after laser or other types of incisional surgery and does not preclude or affect the outcome of future surgery. It can also be combined with cataract surgery in order to maximize IOP reduction while also making the best use of your operating time.
Addressing the full treatment spectrum of the glaucoma disease process, Canaloplasty can be performed via both ab externo and ab interno approaches to Schlemm’s canal in order to best meet your patient’s requirements.
How Does Canaloplasty Work?
Most glaucoma treatments fail to completely address the natural outflow system and may even disturb the natural outflow function. 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:
STEP 1: 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
STEP 2: 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
STEP 3: The dilation of the canal also opens up the collector channels which transport the fluid into the circulation system
STEP 4: 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 Should I Expect After Treatment?
After the surgery, you may feel some slight irritation under the eyelid until the sutures have fully resorbed. You may also see some bleeding in the front of the eye. This is usually a sign that the connection between the circulatory system and the aqueous outflow has been restored and that the surgery has been successful. Your surgeon will schedule one or more post-operative visits to ensure that everything is going smoothly and to check your IOP, and will prescribe drops to soothe your eye and prevent infection. You can resume normal, day-to-day activities, such as watching TV, immediately following treatment.
It is important to remember that managing glaucoma is a lifelong process: even after Canaloplasty and other glaucoma treatments, you will need to continue to visit your ophthalmologist every three to six months.
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.
Quick Facts of Canaloplasty
Canaloplasty is a “non-penetrating” surgical procedure. That is, it does not require the creation of a permanent hole nor does it result in a “bleb” (blister).
Canaloplasty has a well-established track record of success among many races. In contrast, traditional glaucoma surgery has a high failure rate among African American patients.
Canaloplasty has been clinically proven to provide long-term reduction in IOP. To date, more than 35,000 procedures have been performed.
Canaloplasty is safer and offers more predictable outcomes than traditional glaucoma surgery (trabeculectomy).
Canaloplasty is a restorative treatment for the eye’s natural drainage system. By restoring your eye’s natural drainage system, Canaloplasty usually lowers the pressure inside your eye. In contrast, traditional glaucoma surgeries bypass the eye’s natural outflow pathways.
Canaloplasty can reduce your dependence on expensive anti-glaucoma medications.
Canaloplasty is minimally invasive for quicker recovery and minimal post-operative follow-up, allowing you to return to normal day-to-day activities almost immediately following treatment.
With Canaloplasty there is less risk of complications versus traditional surgical alternatives.
To schedule an ophthalmic consultation with one of our eye care specialists call (910) 484-2284 and see if your a candidate for Canaloplasty.
To learn more visit www.canaloplasty.com