Finally, a head-to-head trial comparing the glaucoma surgeries trabeculectomy and canaloplasty [1]. And, the results heavily favor the safety of canaloplasty over trabeculectomy while also showing an impressive intraocular pressure reduction with canaloplasty. Even more noteworthy is a strong statement made by Dr. Kai Januschowski supporting canaloplasty over trabeculectomy as a “first line” surgical treatment. I am hopeful other glaucoma surgeons will heed this message.
This changes the dynamics of the surgical approach for treating glaucoma patients: It makes canaloplasty the first-line surgical strategy yielding the same IOP-lowering potential with less severe side-effects than trabeculectomy and more attractive postoperative strategies if target IOP is not reached. Trabeculectomy will in our eyes remain an attractive second line therapy besides deep sclerectomy.
We should be asking ourselves the question: which of the two equal IOP-lowering procedures is preferable – the one with 50% chance of having to use additional topical therapy [canaloplasty] or the one with a 25% possibility for additional topical therapy but with high chances of severe intra- and postoperative complications and failure [trabeculectomy].
Dr. Kai JanuschowskiUP NEXT: My thoughts on the recently published Trabeculectomy vs. Canaloplasty trial. Subscribe to our newsletter so you won’t miss it!
References
- Matlach J, Dhillon C, Hain J, Schlunck G, Grehn F, Klink T. Trabeculectomy versus canaloplasty (TVC study) in the treatment of patients with open-angle glaucoma: a prospective randomized clinical trial. Acta Ophthalmologica. 2015;93(8):753-761.[2] Januschowski K, Leers S, Haus A, Szurman P, Seuthe A, Boden K. Is trabeculectomy really superior to canaloplasty?. Acta Ophthalmologica. 2016;:n/a-n/a.
Don’t delay getting checked for glaucoma.
Make an appointment with an eye doctor in your area now. If you live in the greater Los Angeles area and would like Dr. Richardson to evaluate your eyes for glaucoma call 626-289-7856 now. No referral required. Appointments are available, Tuesday through Saturday.
In The Same Series:
- Trabeculectomy Surgery For Glaucoma
- Why Trabeculectomy is the Most Common Glaucoma Surgery
- Risks of Trabeculectomy (Part 1 of 2)
- Risks of Trabeculectomy (Part 2 of 2)
- When Should Trabeculectomy Be Considered?
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)
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.
