Efficacy of Ab Interno Canaloplasty Followed By Trabeculotomy in Pseudophakic Eyes with OpenAngle Gl

Efficacy of Ab Interno Canaloplasty Followed By Trabeculotomy in Pseudophakic Eyes with Open-Angle Glaucoma

2021

Author: Adam Bleeker, MD

Contributors: Mitch Ibach OD, Daniel Terveen MD, Michael Greenwood MD, John Berdahl MD

Purpose:

To evaluate short-term outcomes of combined ab interno canaloplasty and trabeculotomy in pseudophakic eyes with open-angle glaucoma.

Methods:

This was a multi-site, non-randomized, retrospective case series including pseudophakic eyes with uncontrolled open-angle glaucoma treated with up to 360° canaloplasty followed by up to 360° trabeculotomy using a purpose-engineered device (OMNI, Sight Sciences Inc). Patients were examined preoperatively then postoperatively at one day, one week, one and three months. Primary outcome measures were mean IOP and number of glaucoma medications.

Results:

The study included 67 eyes of 52 patients with a mean age of 76.5 ± 8.9 years. Preoperative mean IOP was 22.1 ± 8.0 mmHg on 2.3 ± 1.4 glaucoma medications. Pressure lowering effects were sustained out to six months postoperative with a mean IOP was 15.2 ± 4.9 mmHg (p<0.001) with a mean medication reduction of 0.7 ± 1.4 (29% reduction; p<0.001). Proportional analysis revealed that 40% of eyes had an IOP <15 mmHg at 6 months postoperative. Similarly, 79% of eyes had an IOP <18 mmHg at 6 months postoperative. Two patients required a second glaucoma surgery.

Conclusions:

Ab interno canaloplasty followed by trabeculotomy is an effective means of significantly reducing IOP and medication burden in pseudophakic eyes with mild to severe open-angle glaucoma.