Glaucoma Surgery - Canaloplasty

Canaloplasty is a Proven Effective Glaucoma Surgery to Reduce Intraocular Pressure and Possibly Eliminate All Eye Drop Medicines

Canaloplasty is an FDA approved surgery for primary open angle glaucoma patients that has proven safe and effective for reducing intraocular pressure.  Canaloplasty can be performed alone or simultaneously with cataract surgery and was first performed in 2005. 

Canaloplasty widens Schlemm’s canal, which runs 360 degrees internally inside the eye behind the outside perimeter of the cornea.  The purpose of Schlemm’s Canal is to collect excess aqueous fluid and drain the fluid into the body’s bloodstream for excretion. Glaucoma can be caused by blockage of this canal or the nearby filtration meshwork called the trabecular meshwork. Since new aqueous fluid is always being made by the ciliary body inside the eye, an equal amount of fluid must filter out of the eye via the Trabecular Meshwork and then through Schlemm’s Canal or the intraocular pressure will increase causing damage to the optic nerve, retina nerve fiber layer and retinal ganglion cells of the eye. A canaloplasty is a minimally invasive procedure that uses a microcatheter manufactured by iScience Interventional, Menlo Park, California, to widen the canal. This ultimately improves the natural drainage of the aqueous fluid to decrease the intraocular pressure (IOP).

The Canaloplasty Procedure

· An ultrasound imaging system is used to see inside the canal for the precision and accuracy during the procedure.

· A thin flap of tissue is made in the sclera (white outer part of the eye).

· A small incision is made to give access to Schlemm’s canal.

· A microcannula (iScience Interventional) with a light at the front end and a suture attached to the other end is then threaded 360 degrees through the canal. There is also a narrow tube for a gel substance (viscoelastic) to be sent through the canal to widen Schlemm’s canal.

· After the microcatheter is withdrawn, the suture is tightened slightly to create some tension before it is tied.  The tension helps Schlemm's canal stay open and improves the drainage of the aqueous.

· The scleral flap is firmly repositioned and the overlying conjunctiva is sutured back in place.

Results of PhacoCanaloplasty

When the canaloplasty is combined with cataract surgery it maximizes the results.

Proven PhacoCanaloplasty results have shown:

• 45% IOP reduction after 3 years post-op
• Over 80% decrease in daily eye drop medicine after 3 years
• Low rate of post-op complications
• 88% of patients require no glaucoma medication