If you have had either of the laser surgeries for open angle glaucoma (Argon Laser Trabeculoplasty or Selective Laser Trabeculoplasty), you may still be a candidate for Canaloplasty. It depends, however, on how much scarring there is from the laser surgery. Although your surgeon can visually inspect the area around Schelmm’s canal using a special contact lens (a technique called gonioscopy), s/he cannot tell if there has been permanent scarring of the canal itself. It may not be possible to fully catheterize the canal if there is dense scarring of the canal (called stenosis). In that case, your surgeon would not be able to stent the canal open with a suture, but would still inject a special gel (called a viscoelastic) into the partially opened canal. When the canal cannot be fully cannulated and the stent is not placed, this is called viscocanalostomy. Although not as effective as canaloplasty, it can still lower the IOP.

Possibly. Remember that the primary objective of any glaucoma surgery (including Canaloplasty) is to lower your IOP into a safer range and protect you from further loss of vision. A secondary goal would be to reduce (or even eliminate) the use of glaucoma drops. Studies have shown Canaloplasty to be effective at achieving both of these goals. Not only do most people who undergo Canaloplasty have lower IOPs after surgery, but on average, they are able to stop just under two medications. What does “just under two” mean? Well, some people are able to stop one drop, some two, others none and some are even able to stop all of their drops. How many you will be able to stop if you have Canaloplasty cannot be predicted, though it’s likely that you will be able to stop at least one of them if you are on multiple drops.

The amount charged for canaloplasty varies by surgeon and surgery center. If you do not have insurance, the total cost for canaloplasty can range from $4,000 to upwards of $8,000 per eye. Fortunately, Medicare and many insurances pay for Canaloplasty when surgical treatment of glaucoma is indicated. Even if you do not have insurance, however, Canaloplasty can pay for itself over time simply by saving you $1,000s per year in the cost of glaucoma drops that may no longer be necessary after this surgery.

Yes. A recent study compared one year results of Canaloplasty vs. trabeculectomy. Although there was no significant difference in the final intraocular pressures (IOPs) between the two surgeries (meaning both surgeries were equally good at lowering IOP), two differences were noted:

1. Canaloplasty patients experienced fewer side effects and complications compared to those who had trabeculectomy; and

2. The patients who had Canaloplasty had better vision than those patients who had trabeculectomy. For a more in-depth comparison, please read Canaloplasty versus Trabeculectomy.

Yes, but you may have to wait until the eye is healed from surgery. How soon you may restart use of contact lenses will be up to your surgeon. Additionally, it may be necessary to get fitted for new contact lenses after Canaloplasty as the surgery can sometimes change your refractive error. Contrast this with traditional glacuoma surgery (trabeculectomy). Because of the fragile nature of a bleb after trabeculectomy (and the risk of rupture and/or infection), once someone has had trabeculectomy surgery s/he cannot wear soft contact lenses after surgery for as long as the bleb is functioning. Hard contact lenses, however, are generally OK to wear even with trabeculectomy (though a refitting may be needed after surgery).