Featured in Newsday!

8/20/07

Technology Lets Surgeons Utilize Smallest Catheter Ever Inserted in Human Body

...On July 26th, 60-year-old Stephen D’Orio, of Plainview, Long Island, became the first patient in the greater New York area to undergo a breakthrough surgery known as canaloplasty. This is a new, FDA-approved interventional procedure for the treatment of open angle glaucoma. Using the latest technology, the canaloplasty procedure is designed to restore the eye’s natural fluid balance and IOP. During the minimally invasive procedure, the surgeon inserts a microcatheter through a small incision in the eye to enlarge the main drainage channel and its associated collector channels. The surgeon places and tightens a small suture inside the canal to maintain the opening so it can function normally again. This combination of dilation, suture placement and tightening helps to restore the eye’s natural drainage capability and aids the eye in maintaining normal intraocular pressure.

According to Craig Marcus, MD, FACS, the surgeon who operated on Mr. D’Orio, “Canaloplasty is a wonderfully exciting new procedure that not only allows us to restore the eye’s natural drainage system and lower IOP, but we may also be able to reduce the need for costly medications.” Dr. Marcus explained that following this new type of surgery, many patients don’t need the medications they used previously to control IOP. And, he added, many patients are not able to tolerate the mix of medications that are prescribed for this condition, so canaloplasty offers a gentler, more affordable option for the patient who is deemed a successful candidate.

Aside from medications, which must be taken daily and can be very expensive, a more traditional and invasive type of glaucoma surgery called trabeculectomy could be considered as a potential treatment option…however, based on data reported in peer reviewed journal articles, these traditional procedures can result in a higher rate of postoperative complications.

When compared to the previously mentioned , more traditional surgery, canaloplasty’s use of a microcatheter to access and restore the natural structure anatomy of Schlemm’s canal results in a minimally invasive outpatient procedure.

Now two weeks post-surgery, Dr. Marcus reports that Mr. D’Orio’s IOP has dropped well within the normal range. Had there been no intervention, Mr. D’Orio would have most certainly lost his vision.

During today’s press conference, Dr. Marcus showed footage of the procedure, which can sometimes be completed in less than one hour. And, Mr. D’Orio reported that he is very happy to be rid of his daily dose of four glaucoma medications.

Our practice prides itself on its use of the best technology to diagnose, track, and heal. Here are some of the devices we use to provide the best care:

YAG Laser : One use for a YAG laser in surgery is to punch a hole in the iris to relieve increased pressure within the eye from acute angle-closure glaucoma. In this type of glaucoma, there is a sudden (acute) increase in pressure in the anterior (front) chamber of the eye due to abrupt blockage of the normal circulation of fluid within the eye.YAG laser surgery is also used for cataracts.

Heidelberg Retina Tomograph: Three-dimensional optic nerve head topography analysis by laser scanning tomography has been shown to be superior to many other imaging technologies. Because of its advantages, this technology is now generally accepted and used to provide the best service possible for glaucoma patients and patients at risk.

Humphrey Visual Field: The Humphrey Field Analyzer II-i series is a wheelchair accessible, computerized perimeter used to examine the patient's visual field. By using SITA™, the expert operating systems threshold testing time is reduced by up to 70%.
A patented aspherically shaped bowl provides a compact, ergonomic design to increase patient comfort while testing out to 90º. A video eye monitor enables the operator to align and track patient eye position. Gaze tracking provides real time evaluation of eye fixation.

Ahmed Valve Implant: The Ahmed™ Glaucoma Valve (AGV) uses state of the art technology and innovation in controlling intraocular pressure (IOP), lowering the chance of hypotony, and reducing drug use. The AGV is effective in all types of glaucoma due to its unique valve system. Exhibiting a level of control only a true valve can offer.