New glaucoma surgery avoids penetration

LOS ANGELES The effects of glaucoma are slow and insidious. Most people don't even notice anything is wrong until it's too late.

Managing glaucoma involves a series of eye drops and then surgery once the problem reaches its end stages.

Now there's a new procedure designed to prevent glaucoma from progressing.

First, his right eye, then his left. arry Inao, 80, hopes a final procedure will stop his glaucoma from getting worse. His doctor warned him to take action.

"He said, 'Oh, your pressure is too high. You could go blind if it keeps going up,'" said Inao.

In glaucoma, the eye's drainage system doesn't work. Fluid buildup puts pressure on the optic nerve and eventually destroys vision.

The first line of treatment: eye drops to control fluid retention. But the drops made Inao's eyes very dry. Next he tried a laser treatment, but the benefits didn't last. The last resort: surgery.

"The traditional surgery, called tribeculectomy, has quite a few risks associated with it," said Dr. David Richardson, San Gabriel Valley Medical Center.

In the most common surgical procedure for glaucoma, doctors penetrate the eye and create a hole to reduce the pressure. In canaloplasty it's completely different. Doctors say to think of it as "angioplasty for the eye."

"With canoloplasty we do not penetrate the eye," said Richardson.

Instead, Richardson cuts a tiny flap at the top of the eye. Surgeons find an opening in the eye's natural drainage system, insert a micro-catheter to expand the canal and then keep it open with a stent.

"This surgery is really the first surgery that allows us to give patients with glaucoma a surgical treatment before they get to that end stage of glaucoma," said Richardson.

That's why Inao chose canaloplasty. The biggest risk, Richardson says, is occasionally it's not effective. But if Inao's left eye works as well as his right, he won't have to worry about glaucoma treatments for the rest of his life.

"I might be 80 years old, but I might live to be a hundred, I don't know," said Inao.

Canaloplasty is recommended for patients with open-angle glaucoma, the most common form.

If you've already had glaucoma surgery then you're not a candidate.

Only about a dozen local doctors perform canaloplasty. Richardson says more and more insurance companies are starting to cover it.

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