"There's a hole in my bucket, dear Liza, dear Liza,
There's a hole in my bucket, dear Liza, a hole.
Then fix it, dear Henry, dear Henry, fix it. "
"With what I'll fix it, dear Liza, dear Liza?
With what shall I fix it, dear Liza, with what?
With a straw, dear Henry, dear Henry, a straw. "
Does this song sound familiar? Sesame Street incorporated the song as a comedic skit in the 1970s except instead of a "straw," the hole in the bucket was fixed with a "stick". The same holds true with canaloplasty. To fix the leaky bucket (glaucoma), a straw is needed (microcatheter).
Canaloplasty is a recent advancement in non-penetrating glaucoma surgery that gains aqueous outflow without forming a bleb (blister). This approach does not create a full-thickness hole into the fluid-filled space inside the eye (anterior chamber), as with trabeculectomy. Instead, the eye fluid flows slowly through the natural drainage channels with the help of a stent, preventing a rapid and dangerous drop in eye pressure. This gives canaloplasty an excellent safety profile, with early eye pressure stability after surgery and faster recovery time. It also means less activity restrictions and post-operative visits for patients when compared to trabeculectomy.
In addition, canaloplasty and trabeculectomy both resulated in similar reductions in intraocular pressure (IOP) and medication use one year after surgery. Experts agree that canaloplasty is a desirable option for glaucoma patients because it decrees the number of necessary post-operative visits and there are fewer complications to treat. As an added bonus, patients save thousands of dollars in the cost of medications because cancaloplasty reduces the amount of medication patients need in order to control the IOP. The ultimate result? A happier patient who can go back to enjoying life without restrictions.
Although anyone with open angle glaucoma can benefit from canalopalsty, it is especially valuable for patients who are also contact lens wearers, have eyes with significant ocular surface disease (dry eyes), and those individuals with a failed trabeculectomy in the other eye. Because of the improved safety profile, canaloplasty will likely have an increasing role in the surgical management of patients with glaucoma.