Eyeworld

EW GLAUCOMA 77 a fair number of mild to moderate glaucoma patients," he said. "The patient population is there. Some- times it's not always recognizable who might be an appropriate candi- date, but those populations exist." Dr. Noecker breaks canaloplasty candidates into four groups: mild to moderate glaucoma patients, African Americans, lifestyle patients, and those at risk for hypotony, as long as these individuals are not at the end stage of the disease. "It's for someone who I'm not expecting to get a single-digit eye pressure," he said. African Americans should be considered because they tend to scar during trabeculectomy, and surgeons spend a lot of time battling the nor- mal healing process post-op. "The nice thing with canalo- plasty is you're not treating this hole to the outside surface of the eye. You're not dependent on how [a pa- tient] heals up," Dr. Noecker said. "So if the conjunctiva scars down, that's fine. You basically have the procedure working by increasing outflow through the normal collec- tor system." Lifestyle patients tend to have a young demographic. Because the risk of a bleb is so high with tra- beculectomy, you want to avoid it in those who wear contact lenses and in patients with dirt- and dust-filled occupations like a farmer or me- chanic. "We can do a trabeculectomy but we're skittish about it," he said. "We're going to worry about those patients over the long term. What's great about canaloplasty is once you're through the immediate post- op period, it's done. Nothing bad is going to happen. There are some people it doesn't work as well on, but you're not going to get a surprise infection later on." Finally, canaloplasty is good for patients at risk for hypotony and those who shouldn't have a single- digit pressure because of the risk of choroidal effusion. A single-digit pressure may not be bad for their glaucoma, but it can be bad for their vision. These people are typically young myopes with big, floppy eyes. Or it's someone who has had a vit- rectomy and a macula repair and doesn't have enough vitreous in the eye. Canaloplasty "is nice to do in those populations because you're very unlikely to overshoot and get a pressure in the single digits," Dr. Noecker said. One of the best parts about canaloplasty is it doesn't prevent other glaucoma surgeries later on. If it doesn't work, trabeculectomy, tubes, and shunts are still options. "Canaloplasty is ushering in this new generation of procedures that are going to give greater diversity for surgical glaucoma therapy," said Dr. February 2011 September 2011 • Industry Leading Resolution • 100% Measurement Capability including dense cataracts • Automatic Alignment Detection • Simplified Personalization of Lens Constants • Unlimited patient data storage, recall, and transfer via USB Memory Stick Every purchase of an A-Scan Plus 4.20 comes with an on-site training program. Receive a Free Toric Marker with Purchase 3222 Phoenixville Pike, Malvern, PA 19355 • USA 800-979-2020 • 610-889-0200 • FAX 610-889-3233 • www.accutome.com Product #24-4200 Right On Target... The New A-Scan Plus ® 4.20 Right On Target... The New A-Scan Plus ® 4.20 Meeting the Needs of Your Premium IOL Patient Visit Us At AAO Booth #628 continued on page 78

• Cover