Is Trabeculectomy an Option After Canaloplasty?
Is Trabeculectomy an Option after Canaloplasty? One of the common misconceptions about Canaloplasty is that it eliminates the future option a Trabeculectomy . It’s also, sadly, one of the more common reasons patients chose not to have Canaloplasty when their glaucoma is severe enough that it requires surgical treatment. Surgeons who do not perform (or only infrequently perform) Canaloplasty may have the impression that trabeculectomy cannot be performed after Canaloplasty. Why would this be so? Well, as a general rule, once you have had surgery on the conjunctiva it is technically more challenging to perform trabeculectomy due to the scarring from prior surgery. Even if the surgery can be successfully performed, trabeculectomies after prior eye surgery are more likely to fail. As Canaloplasty is performed by creating a conjunctival flap in the area of the eye commonly used for other glaucoma surgeries, it’s reasonable for surgeons who have little experience with Canaloplasty to assume that trabeculectomy would also be difficult or prone to failure after Canaloplasty.
Experienced Canaloplasty surgeons, however, have been aware for years that the conjunctiva in the area of prior Canaloplasty has a very normal appearance with minimal scarring. This is very different than the expected conjunctival scarring seen after other glaucoma, retinal or older style cataract surgeries. Among experienced Canaloplasty surgeons it has also been accepted that Canalolplasty does not limit a skilled surgeon’s ability to perform either a trabeculectomy or placement of a tube implant (Ahmed, Baerveldt, or Molteno) in the area of prior Canaloplasty surgery. Unfortunately, this was considered hearsay by most glaucoma surgeons with little or no experience with Canaloplasty.

David Richardson, MD
Medical Director, San Marino Eye
David Richardson, M.D. is recognized as one of the top cataract and glaucoma surgeons in the US and is among an elite group of glaucoma surgeons in the country performing the highly specialized canaloplasty procedure. Morever, Dr. Richardson is one of only a few surgeons in the greater Los Angeles area that performs MicroPulse P3™ "Cyclophotocoagulation" (MP3) glaucoma laser surgery. Dr. Richardson graduated Magna Cum Laude from the University of Southern California and earned his Medical Degree from Harvard Medical School. He completed his ophthalmology residency at the LAC+USC Medical Center/ Doheny Eye Institute. Dr. Richardson is also an Ambassador of Glaucoma Research Foundation.
Canaloplasty FAQ Videos (with Transcript)
- How Long Does Canaloplasty Take?
- How Long Will my IOP Stay Controlled With Canaloplasty?
- How Will I Need To Limit My Activities After Canaloplasty?
- How Long Has Canaloplasty Been Around?
- Why Choose Canaloplasty?
- Why Do I Perform Canaloplasty as My Primary Glaucoma Surgery?
- What Does Minimally Invasive Mean?
- What If My Natural Drainage Canal Cannot Be Fully Catheterized?
- What Are the Risks of Canaloplasty?
- What Is The Big Deal About A Bleb Anyway?
- What If Canaloplasty Doesn't Work, Can I Still Have Traditional Glaucoma Surgery?
- Is Canaloplasty Surgery Painful?
- Is Eliminating Drops Worth The Risk Of Having Canaloplasty?
- Is Canaloplasty Really Safer Than Trabeculectomy?
- Is Trabeculectomy an Option After Canaloplasty?
- Will My Insurance Cover Canaloplasty?
- Will My Vision Change After Canaloplasty?
- Will Canaloplasty Cure My Glaucoma?
- Will I Be Able To Stop Using Glaucoma Drops After Canaloplasty?
- I Have Had Glaucoma Laser Surgery, Can I Have Canaloplasty?
- I Already Had Traditional Glaucoma Surgery, Trabeculectomy. Can I Have Canaloplasty?
- I Have Used Glaucoma Drops for a Long Time, Will That Affect the Success of Canaloplasty?
- I Have Heard That Canaloplasty Is Not As Effective As Trabeculectomy
- Can I Continue To Wear Soft Contact Lenses After Canaloplasty?
Related Articles:
- What Is The Big Deal About A Bleb?
- Is Trabeculectomy an Option After Canaloplasty?
- PhacoCanaloplasty™ vs Phacotrab
- 1 in 5 Trabeculectomy Patients May End up With Ptosis (Eyelid Droop)
- Trabeculectomy versus Canaloplasty (TVC study)
- Trabeculectomy Glaucoma Surgery After Canaloplasty
- Trabeculectomy Glaucoma Surgery (Part 3 of 12 of “What’s New In Glaucoma Surgery” Presentation)