On Wednesday I underwent canaloplasty, a surgical treatment for glaucoma in my right eye.
Canaloplasty is a new advanced treatment that unclogs the Schlemm's canal which collects the aqueous humor from the anterior chamber of the eye and disperses it.
In a pigmentary glaucoma like mine, the canal gets clogged by particles of pigment from the iris.
I decided to go for this treatment, despite contrary opinions of my ophthalmologists in Pisa and Barcelona, since it looked to me a better solution than creating an artificial channel through the eye, as in trabeculectomy or drainage implants, which are more conventional solutions.
Restoring the natural flow sounded like the right idea: the only problem is that the surgical procedure is complex and requires a good eye surgeon.
There are only about a dozen of them in Europe.
I found one in Udine, dr. Paolo Brusini, who has been a pioneer performing it since a couple of years.
The surgery requires passing a microcatheter all the way through the Schlemm's canal, i.e. 360 degrees around the iris. The catheter is a tiny fiber optic with a light on top, so that the surgeon can see its position.
Despite the anesthesia I could feel the catheter moving within the eye.
Brusini started from the top moving counterclockwise but when reached 8 hours it found a blockage.
It was a moment of tension, then Brusini decided to remove the catheter and to try in the other direction.
This time the blockage was removed and the catheter reappeared from the end of the channel.
It was a moment of cheer and I heard a sigh of relief from Brusini and his collaborators.
The whole operation took more than an hour and Brusini said that all canaloplasty operations are quite stressful for him, and indeed he had to take a rest after finishing.
I am very grateful to Brusini for his competence, dedication and passion in his work. He and his team at the Udine Hospital have been very competent and kind.
It is just a pity that surgery rooms and other facilities for his clinic are not enough and hence the waiting list is long.
The day after surgery I was released and I can already behave normally as the eye completes recovery.
The pressure in the eye is down to 12 mmHg, from levels up to 40 in the days before surgery, despite the use of drops and diuretics to control it.
Canaloplasty is a new advanced treatment that unclogs the Schlemm's canal which collects the aqueous humor from the anterior chamber of the eye and disperses it.
In a pigmentary glaucoma like mine, the canal gets clogged by particles of pigment from the iris.
I decided to go for this treatment, despite contrary opinions of my ophthalmologists in Pisa and Barcelona, since it looked to me a better solution than creating an artificial channel through the eye, as in trabeculectomy or drainage implants, which are more conventional solutions.
Restoring the natural flow sounded like the right idea: the only problem is that the surgical procedure is complex and requires a good eye surgeon.
There are only about a dozen of them in Europe.
I found one in Udine, dr. Paolo Brusini, who has been a pioneer performing it since a couple of years.
The surgery requires passing a microcatheter all the way through the Schlemm's canal, i.e. 360 degrees around the iris. The catheter is a tiny fiber optic with a light on top, so that the surgeon can see its position.
Despite the anesthesia I could feel the catheter moving within the eye.
Brusini started from the top moving counterclockwise but when reached 8 hours it found a blockage.
It was a moment of tension, then Brusini decided to remove the catheter and to try in the other direction.
This time the blockage was removed and the catheter reappeared from the end of the channel.
It was a moment of cheer and I heard a sigh of relief from Brusini and his collaborators.
The whole operation took more than an hour and Brusini said that all canaloplasty operations are quite stressful for him, and indeed he had to take a rest after finishing.
I am very grateful to Brusini for his competence, dedication and passion in his work. He and his team at the Udine Hospital have been very competent and kind.
It is just a pity that surgery rooms and other facilities for his clinic are not enough and hence the waiting list is long.
The day after surgery I was released and I can already behave normally as the eye completes recovery.
The pressure in the eye is down to 12 mmHg, from levels up to 40 in the days before surgery, despite the use of drops and diuretics to control it.
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7 comments:
Sono veramente contento che tutto sia andato più che bene.
Dario.
That's great news! Maybe you could go back to the other doctors and show them your success so their patients can benefit from Canaloplasty as well!
Hello, I´m Edgar Mora from Mexico City, I saw your Blog about the Canaloplasty, and I´m very interested in, cause I have Open angle Glaucoma, unfortunately here in Mexico there is no place where practice this surgery, and I would like to Know how does it works the canaloplasty in your eyes 2 years after, and if you would be able to send me the email and how to contact to Dr. Paolo Rosini? I really appreciate this informatión
My email is morscarpi@gmail.com
Thanks
Edgar
Hello, I´m Edgar Mora from Mexico City, I saw your Blog about the Canaloplasty, and I´m very interested in, cause I have Open angle Glaucoma, unfortunately here in Mexico there is no place where practice this surgery, and I would like to Know how does it works the canaloplasty in your eyes 2 years after, and if you would be able to send me the email and how to contact to Dr. Paolo Rosini? I really appreciate this informatión
My email is morscarpi@gmail.com
Thanks
Edgar
So far things are going quite well and the IOP is at 16, lower than in the other eye treated earlier with trabeculectomy.
I will send you separately the email of Dr. Brusini, but you can find it also in the site of the Hospital.
Salve signor Attardi, e mi scusi sin d'ora per l'intrusione telematica.
Mi presento: mi chiamo Roberto, ho quasi 33 anni, e dal Dicembre del 2012 ho scoperto di essere affetto da glaucoma pigmentario evoluto all'occhio destro. Ho avuto un o sbalzo di pressione di più di 30 mm, ed ho già perso il 60% del campo visivo dall'occhio malato. Da quando però ho cominciato la terapia farmacologica, la mia pressione intraoculare è arrivata al massimo a 20/21 mm, rimanendo anzi spesso stabile tra i 18 e 19 mm. Eppure, continuano a dirmi che mi devo operare di trabeculectomia, perché la mia tipologia di glaucoma è caratterizzata da saltuarie esplosioni e picchi improvvisi di pressione, che mi faranno perdere quel poco di campo visivo rimasto all'occhio destro. La trabeculectomia però mi spaventa non poco, è davvero un'operazione cruenta e dalle conseguenze a dir poco nefaste. Infatti ho già parlato col dottor Brusini, e ci siamo lasciati con la promessa di rivederci dopo il mio secondo campo visivo (che sarà ad Aprile).
E qui vengo a lei. Vorrei cioè chiederle se la sua esperienza è stata positiva, se la pressione intraoculare con la canaloplastica è scesa notevolmente ma soprattutto sabilmente, se è costretto ad usare farmaci di qualche tipo, come l'insopportabile Pilocarpina che mi rende miope/ quasi cieco per almeno 3 ore. Ed ancora, secondo lei, il mio caso necessita davvero di un'operazione? Io ho spesso sentito parlare di persone di 60 anni che convivono senza problemi con glaucoma semplicemente usando colliri (e neanche Diamox o altri diuretici). Continuo quindi ad essere ancora parecchio scettico su ciò che mi hanno detto, dato che i miei picchi non superano mai i 20/21 mm. Ma di questo ne parlerò con Brusini stesso durante la nostra prossima visita.
Per il resto, mi saprebbe dire come lei vive adesso, dopo l'operazione? Ha qualche impedimento di sorta, qualche fastidio? E l'effetto della canaloplastica, che durata ha? 3,4,5 10 anni o ancora di più?
Io sto pensando anche a quell'operazione proposta dal dottor Nardi di Siena, tramite la quale viene inserita una micro lamina di oro a 24 carati nell'occhio, poco invasiva e senza le conseguenze nefaste della trabeculectomia.
Le chiedo venia se sono stato troppo prolisso e se le ho fatto troppe domande, e spero che lei stesso stia vivendo la sua vita senza ulteriori problemi di vista e senza paura di perderla; è la paura più grande, a mio avviso, quella di non poter più vedere, soprattutto se si è ancora giovani ed "in bilico" sia lavorativamente che per ogni altro motivo.
La ringrazio per una sua eventuale risposta, le auguro buona serata
La pressione varia tra 12 e 20. Credo che il dr. Brusini le potrà dare il miglior consiglio dopo la visita.
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