iScience – ASCRS 2012: Canaloplasty Didactic
Course Dr. Sinskey, thank you for joining us here
tonight. I think it would be interesting to start off
with just a short description of your initial glaucoma diagnosis and the treatment that
was associated with that. When I, you know, all of you ophthalmologist
you have treated all these things but when you sit on the other side of the
table it is a whole different situation. But when I took my oldest daughter and her
family to Alaska, on a cruise, and I noticed on a cruise (that
was in the year 2000, 12 years ago). I noticed there was a little difference in
contrast sensitivity in the two eyes. And when I was a resident at Duke,
we used to practice tactile tension on each other and see if we could guess it right,
and we could guess it right pretty good actually. And I have never lost that completely.
So I began to check myself on the boat and realized that this pressure was higher in
this eye than this eye and when I got back, I had my nurse checked
the pressure and this was 26 in this eye and 17 in this
eye. Also the cap was slightly larger than this
eye, then the other eye my visual fields were normal
so I started treatment then. Actually I’ve had ALT and SLT.
It is an exfoliative type of glaucoma. My family history goes back to the Ukraine
where it is very common to have exfoliative type of glaucoma, exfoliation.
So I went along fine for years with these various treatments,
and I am allergic to beta…. I have got asthma with beta blocker so I could not take Timoptic.
But I’ll be in Xalatan and when it started to get out of control I got into the Pilocarpine
and that is, and I even got into the*****, which I had a hard time dealing with it.
It just gets a little scary. So anyway, I decided I am getting neurosurgery
and I didn’t want to wait till I got severevisual field defects,
so sometimes it also seems to get going no matter what.
So I did, in my own experience with treating glaucoma and I have probably
treated thousands but I was very happy to be firm
when I got thoroughly involved with cataract surgery and implant surgery.
And I was happy to send all my glaucoma patients to somebody who really knew what they were
doing or I would say thought knew what they were
doing. So I did not want to have a filtering operation.
So I checked around and canaloplasty came up.
I am on the advisory board of the Duke Eye Center,
where I took my residency and they mentioned canaloplasty.
And I called up another friend of mine who is a chair of the *****
and he recommended the same thing and he recommended Rick Lewis up in Sacramento.
So I called up Rick, and went up there, got there 10 o’clock in the morning, it
was about 110 in the shade, in August. Sacramento is a hot town for temperature reasons
anyway. Anyway, he operated on me at 1 o’clock
and my wife seating over here drove me over to Napa,
because I have a home over in Napa. And check the pressure the next day, it was
running 30 and the next day it was down to 8.
Then I got a little nervous, because when I came back down to Sta.Monica
and I have a young doctor in a… the child next to me that does the same thing,
but his only done about (a hundred) ten or fifteen canaloplasty.
So the pressure went back up to 25 and 26, 28 and I was getting nervous
and he said, stop worrying. He says sometimes it takes a couple of months to calm down.
So it is easy for him to say to stop worrying and when you know that you are losing cells
which never come back when the pressure is up,
you are a little nervous. So anyway, I had to check with Rick about 3 weeks later
and it was still up and then 2 months I went back and we both got nervous.
Because I am kinda hard profile type and he decided to blow a hole in descemet’s membrane
and since then, had been 10 and 12, and that was a couple years ago. No drops.
Now speaking of drops, you mentioned the couple of drops that you are on.
How did the drops impact your lifestyle if it all?
Well, the biggest problem when you get to be this age, I am 87.
Is that you are, not only on the… not only the eyedrops, but you own some pills
for your prostate, you own pills for your whatever.
So you own about 10-15 pills and you got to line them all up.
If you travel, the time sequence screws you up that way too,
and you add drops on top of that and then the biggest problem is,“Did I take
the drops or did not I take drops?” or “Did I take the pills or did not I take?”
And you know a lot of people have problems, because they overdose or they under dose.
And so less you do, the happier life is and I cannot tell you the difference between
not worrying about eyedrops in addition to the other stuff.
This is incredible. And you mentioned that you prefer to avoid
a filtering procedure, why was that? What about canaloplasty entice you?
Well, these filtering blebs, are all, you do not know what kind a,
how much is going to bother you, how much it can be irritating a healthy and a *****, was
it going to be? You do not know over leak too much or leak
not enough. And also if you get infected they can cause
endophthalmitis, and I travelled a lot, we have travelled a
lot, we have cut down the travelling a bit, but when you are, it is nice to avoid, I have
house in Ethiopia … I am not really happy about getting in a Russian
infection in Ethiopia or any other place. So the safer the better and the more comfortable
your eye is, It is nice to have comfortable eye without
a bleb. We really appreciate your time. I have one
more question for you. Ok.
Are you satisfied with the outcome of your canaloplasty?
Let me ask you a question? How could I not be satisfied with it?
Thank you very much Dr. Sinskey.