Canaloplasty (pronounced Kah-NAL-oh-plas-tee) is a new glaucoma treatment that gives many people with this potentially blinding condition the hope of saving the vision they have. Canaloplasty can reduce pressure in the eye (IOP) by nearly 40%, and many glaucoma patients who have had Canaloplasty no longer need medications.
If you are not familiar with Canaloplasty, you might want to visit this post first: “What is Canaloplasty?“
Dr. Robert Sinkey is interviewed by Dr. David Richardson at an iScience didactic course at ASCRS 2012. Dr. Sinskey discusses his glaucoma diagnosis, treatment and decision to have Canaloplasty as well as the subsequent outcomes of the procedure.
Dr. David Richardson With Dr. Robert Sinskey At ASCRS 2012: Canaloplasty Q&A
Dr. David Richardson: Dr. Sinskey, thank you for joining us here tonight. I think it would be interesting to start off with just a short description of your initial glaucoma diagnosis and the treatment that was associated with that.
Dr. Robert Sinskey: When I, you know, all of you ophthalmologist you’ve treated all these things but when you sit on the other side of the table it’s a whole different situation. But when I took my oldest daughter and her family to Alaska, on a cruise, and I noticed on a cruise (that was in the year 2000, 12 years ago). I noticed there was a little difference in contrast sensitivity in the two eyes. And when I was a resident at Duke, we used to practice tactile tension on each other and see if we could guess it right, and we could guess it right pretty good actually. And I’ve never lost that completely. So I began to check myself on the boat and realized that this pressure was higher in this eye than this eye and when I got back, I had my nurse checked the pressure and this was 26 in this eye and 17 in this eye. Also the cap was slightly larger than this eye, then the other eye my visual fields were normal so I started treatment then. Actually I’ve had ALT and SLT. It’s an exfoliative type of glaucoma. My family history goes back to the Ukraine where it’s very common to have exfoliative type of glaucoma, exfoliation.
So I went along fine for years with these various treatments, and I’m allergic to beta…. I’ve got asthma with beta blocker so I couldn’t take Timoptic. But I’ll be in Xalatan and when it started to get out of control I got into the Pilocarpine and that’s, and I even got into the *****, which I had a hard time dealing with it. It just gets a little scary. So anyway, I decided I’m getting neurosurgery and I didn’t want to wait till I got severe visual field defects, so sometimes it also seems to get going no matter what. So I did, in my own experience with treating glaucoma and I’ve probably treated thousands but I was very happy to be firm when I got thoroughly involved with cataract surgery and implant surgery. And I was happy to send all my glaucoma patients to somebody who really knew what they were doing or I would say thought knew what they were doing. So I didn’t want to have a filtering operation.
So I checked around and canaloplasty came up. I’m on the advisory board of the Duke Eye Center, where I took my residency and they mentioned canaloplasty. And I called up another friend of mine who is a chair of the ***** and he recommended the same thing and he recommended Rick Lewis up in Sacramento. So I called up Rick, and went up there, got there 10 o’clock in the morning, it was about 110 in the shade, in August. Sacramento is a hot town for temperature reasons anyway. Anyway, he operated on me at 1 o’clock and my wife seating over here drove me over to Napa, because I have a home over in Napa. And check the pressure the next day, it was running 30 and the next day it was down to 8. Then I got a little nervous, because when I came back down to Sta. Monica and I have a young doctor in a… the child next to me that does the same thing, but his only done about (a hundred) ten or fifteen canaloplasty. So the pressure went back up to 25 and 26, 28 and I was getting nervous and he said, stop worrying. He says sometimes it takes a couple of months to calm down. So it’s easy for him to say to stop worrying and when you know that you’re losing cells which never come back when the pressure’s up, you’re a little nervous. So anyway, I had to check with Rick about 3 weeks later and it was still up and then 2 months I went back and we both got nervous. Because I’m kind a hard profile type and he decided to blow a hole in descemet’s membrane and since then, had been 10 and 12, and that was a couple years ago. No drops.
Dr. David Richardson: Now speaking of drops, you mentioned the couple of drops that you’re on. How did the drops impact your lifestyle if it all?
Dr. Robert Sinskey: Well, the biggest problem when you get to be this age, I’m 87, is that you’re not only on the, not only the eye drops, but you own some pills for your prostate, you own pills for your whatever. So you own about 10-15 pills and you got to line them all up. If you travel, the time sequence screws you up that way too, and you add drops on top of that and then the biggest problem is, “Did I take the drops or didn’t I take drops?” or “Did I take the pills or didn’t I take?” And you know a lot of people have problems, because they overdose or they under dose. And so less you do, the happier life is and I can’t tell you the difference between not worrying about eye drops in addition to the other stuff. This is incredible.
Dr. David Richardson: And you mentioned that you prefer to avoid a filtering procedure, why was that? What about canaloplasty entice you?
Dr. Robert Sinskey: Well, these filtering blebs, are all, you don’t know what kind a, how much is going to bother you, how much it can be irritating a healthy and a *****, was it going to be? You don’t know over leak too much or leak not enough. And also if you get infected they can cause endophthalmitis, and I travelled a lot, we’ve travelled a lot, we’ve cut down the travelling a bit, but when you’re, it’s nice to avoid, I’ve hospital inEthiopia … I’m not really happy about getting in a Russian infection in Ethiopia or any other place. So the safer the better and the more comfortable your eye is, it’s nice to have comfortable eye without a bleb.
Dr. David Richardson: We really appreciate your time. I have one more question for you.
Dr. Robert Sinskey: Ok.
Dr. David Richardson: Are you satisfied with the outcome of your canaloplasty?
Dr. Robert Sinskey: Let me ask you a question? How could I not be satisfied with it?
Dr. David Richardson: Thank you very much Dr. Sinskey.
- Canaloplasty, a Lifestyle Surgery for Glaucoma
- Glaucoma Is A Lifestyle Disease 2011
- Canaloplasty The Keys To Optimizing Patients’ Outcomes
- Ophthalmologist in California, Dr. David Richardson At Hawaiian Eye 2012
- Leading Canaloplasty Surgeons’ Call
- Glaucoma Specialists Question Federal Policy on Glaucoma Screening
- ASCRS 2012: David Richardson | Canaloplasty Patient Outcomes at 250 Days Post-Op
- Canaloplasty Surgery [graphic. viewer discretion advised.]
- An Ophthalmologist’s Perspective – Glaucoma is a Lifestyle Disease