Canaloplasty & Trabeculotomy

Canaloplasty is one of several micro-invasive glaucoma surgeries (MIGS) to lower pressure for patients with glaucoma. Canaloplasty can be performed at the time of cataract surgery or as a stand alone procedure. 

It takes advantage of the eye’s natural drainage system to safely reduce eye pressure.

In the past, the most common approach to lowering pressure surgically has been trabeculectomy. This is an invasive surgery that creates a hole in the sclera to let the aqueous fluid drain from inside the eye into a surgically created bubble which we call a bleb. Trabeculectomy surgery has many complication risks including infection, leakage, and long-term irritation and discomfort.

Canaloplasty uses a microcatheter or tube placed in the Schlemm’s Canal (the natural site of drainage for healthy eyes). As the tube is retracted, it releases a clear gel which dilates Schlemm’s Canal. This is very similar to an angioplasty used to open clotted vessels in the heart. Studies have been published showing long-term efficacy and safety with canaloplasty.

Canaloplasty is a useful surgical option in patients with open angle glaucoma, pseudoexfoliation glaucoma, pigmentary glaucoma, and failed SLT. It is sometimes favored in patients at high risk for infection or bleeding, and those patients who have had complications in the other eye from trabeculectomy. Patients who want to continue wearing contact lenses after surgery are also be good candidates for canaloplasty.

The microcatheter used in canaloplasty has already been successfully used in other eye disorders. It is widely used to treat children born with congenital glaucoma in the procedure known as trabeculotomy. In this procedure, the trabecular meshwork covering Schlemm’s Canal is cut open by the microcatheter allowing fluid to flow directly into Schlemm’s Canal.

In summary, canaloplasty and trabeculotomy are safe and innovative procedures taking advantage of the eye’s natural drainage system to safely reduce elevated pressure in eyes with glaucoma.

To learn more about these innovative, micro-invasive procedures, please watch the following video:


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