So why choose canaloplasty over other more traditional glaucoma surgeries such as trabeculectomy or tubes? Well, there are number of reasons but the main one is SAFETY. Canaloplasty is simply a safer surgery and there are multiple studies that look at its safety profile and this can easily be compared with those of trabeculectomy and tubes shunts. For example, it’s very very rare for anyone to lose vision from canaloplasty; it’s not so rare with trabeculectomy. As a matter of fact, with trabeculectomy there’s a lifetime risk of loss of vision from what’s called endophthalmitis. Such a risk does not exist with canaloplasty.
Age is another factor to consider when choosing among glaucoma surgeries. For example, when you’re younger, trabeculectomy tends not to be such a good choice. There are a number of reasons for this. One is that younger people tend to have a more aggressive healing response and healing works against you with trabeculectomy. The only way to avoid that healing response is to use something called an “antimetabolite”, which results in a permanent loss of ability to heal in the area of the eye where the trabeculectomy was performed. This then put somebody in a lifetime risk of infection and loss of vision. Someone who’s very young has many years to be concerned about such a thing. So, for that reason, age factors in favor of canaloplasty, which does not have those lifetime risks that trabeculectomy does.
Another thing to consider is one’s refractive error. For example, people who are very near-sighted or myopic tend not to do well with trabeculectomy. Because of the risk of vision-threatening complications; in particular, one called hypotony or a very low pressure. These complications are simply more common in somebody who is myopic or near sighted and goes ahead with trabeculectomy. Although hypotony can occasionally be seen with canaloplasty, the risk is nowhere near as high as with trabeculectomy. So in general, those with open angle glaucoma, who are near sighted, are better off with canaloplasty than trabeculectomy. If you have an active life style, it’s very important that you consider your glaucoma surgery options carefully. Certain types of glaucoma surgeries, such as trabeculectomy, do not go together well with active lifestyles; especially if that lifestyle involves water sports. Because with trabeculectomy, a small blister-like structures form on the eye that is very delicate and can easily be ruptured. Any kind of activity that could potentially damage that bleb should be avoided. Diving into the water without goggles is one such activity. Therefore, if you have trabeculectomy, for the rest of your life you will need to wear protective goggles, with any type of water sport. Such a restriction simply does not exist with canaloplasty….