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. 2022 Jul 21:16:2295-2303.
doi: 10.2147/OPTH.S367896. eCollection 2022.

Short-Term Efficacy of Combined ab Interno Canaloplasty and Trabeculotomy in Pseudophakic Eyes with Open-Angle Glaucoma

Adam R Bleeker  1 , William R Litchfield  2 , Mitch J Ibach  3 , Michael D Greenwood  4 , Deborah Ristvedt  5 , John P Berdahl  3 , Daniel C Terveen  3
Affiliations

Short-Term Efficacy of Combined ab Interno Canaloplasty and Trabeculotomy in Pseudophakic Eyes with Open-Angle Glaucoma

Adam R Bleeker et al. Clin Ophthalmol. .

Abstract

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

Patients and methods: Series included all pseudophakic eyes with open-angle glaucoma treated with up to 360° ab interno canaloplasty and up to 360° ab interno trabeculotomy using a purpose-engineered device (OMNI, Sight Sciences Inc). Data collected prior to surgery and out to 6-months postoperative. Surgical success defined as a 20% reduction in intraocular pressure (IOP) without increase in glaucoma medication, or discontinuation of at least one glaucoma medication without increase in IOP. Other primary endpoints included 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 6 months postoperative with a mean IOP of 15.2±4.9 mmHg (p < 0.001) and mean medication reduction of 0.7±1.4 (p < 0.001). Surgical success rate was 69.8% (30 eyes) and correlated with preoperative IOP. Two patients required a secondary surgical intervention.

Conclusion: Combined ab interno canaloplasty and trabeculotomy as a standalone procedure is an effective means of reducing IOP and medication burden in pseudophakic eyes with open-angle glaucoma.

Keywords: MIGS; Schlemm canal; glaucoma; pseudophakia.

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Conflict of interest statement

The abstract of this paper was presented at the ASCRS 2021 Annual Meeting as a conference talk with interim findings. The abstract was published online [https://ascrs.org/clinical-education/abstracts/2021/efficacy-of-ab-interno-canaloplasty-followed-by-trabeculotomy-in-pseudophakic-eyes-with-openangle-gl]. Dr Mitch Ibach reports grants from Sight Sciences, during the conduct of the study; personal fees from Allergan, personal fees from Glaukos, personal fees from Sight Sciences, outside the submitted work. Mr Michael Greenwood reports personal fees from Sight Sciences, outside the submitted work. Dr Deborah Ristvedt reports personal fees from Allergan, personal fees from Glaukos, personal fees from Sight Sciences, personal fees from RxSight, outside the submitted work. Dr John P Berdahl reports personal fees from Equinox, personal fees from Glaukos, personal fees from New World Medical, personal fees from Sight Sciences, during the conduct of the study; personal fees from Abbvie, personal fees from Aerie, personal fees from Aerpio, personal fees from Aldeyra, personal fees from Aurea Medical, personal fees from CorneaGen, personal fees from Dakota Lions Eye Bank, personal fees, from Expert Opinion MD, personal fees from Gore, personal fees from Imprimis, personal fees from iRenix, personal fees from Iacta Pharmaceuticals, personal fees from Kala, personal fees from Kedalion, personal fees from MELT Pharmaceuticals, personal fees from MicroOptx, personal fees from Ocular Surgical Data, personal fees from Omega Ophthalmic, personal fees from Orasis, personal fees from Oyster Point, personal fees from Tarsus, personal fees from Surface INC, personal fees from Tear Clear, personal fees from Vertex Ventures, personal fees from ViaLase, personal fees from Vittamed, personal fees, from Vance Thompson Vision, personal fees from Verana Health, personal fees from Visionary Ventures, personal fees from Visus, outside the submitted work. Dr Daniel C Terveen reports grants from Sight Sciences, during the conduct of the study; grants from Sight Sciences, outside the submitted work. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Mean IOP and medication use for complete data set. High level of statistical significance (p < 0.001) for both medication and IOP reduction sustained out to 6-months. Error bars denote standard deviation and asterisks (*) denote statistical significance.
Figure 2
Figure 2
Proportion of eyes within complete data set achieving IOP ≤18 mmHg and ≤15 mmHg at all postoperative timepoints.
Figure 3
Figure 3
Mean IOP and glaucoma medication use stratified by glaucoma severity. IOP was significantly different between mild-moderate and severe disease at baseline and 6-months (p = 0.22; p = 0.03). Medication usage was not significant different between mild-moderate and severe disease at baseline and 6-months (p = 0.52; p = 0.89). Error bars denote standard deviations and asterisks (*) denote statistical significance.
See this image and copyright information in PMC

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