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Combined ab interno canaloplasty and trabeculotomy as a standalone procedure appears to be efficacious in reducing intraocular pressure (IOP) and the medication burden in patients with pseudophakic eyes and open-angle glaucoma, according to research published in Clinical Ophthalmology.
Investigators conducted a retrospective, consecutive case series of 67 pseudophakic eyes of 52 patients (mean age, 76.5±8.9 years; 67.7% women and 33.3% men). with open-angle glaucoma who underwent a combined procedure using a minimally invasive glaucoma surgery (MIGS) device that delivers up to 360° ab interno canaloplasty and up to 360° trabeculotomy without accompanying cataract surgery. They evaluated short-term outcomes, including mean IOP and number of glaucoma medications, and data collected prior to surgery and 6-month after.
The study shows that the pressure-lowering effects of the combined ab interno canaloplasty and trabeculotomy procedure were sustained at 6 months. Patients had a preoperative mean IOP of 22.1±8.0 mm Hg and took on average 2.3±1.4 glaucoma medications. Both those numbers dropped postoperatively to a mean 15.2±4.9 mm Hg (P <.001) and 0.7±1.4 medications (P <.001). The team also observed a surgical success rate (defined as a 20% reduction in IOP with no increase in glaucoma medication, or discontinuation of ≥1 glaucoma medication with no increase in IOP) of 69.8%.
The most common adverse event observed was hyphema (40%) during the immediate postoperative period.
“As evidence supporting the safety and efficacy of MIGS + cataract surgery continues to emerge, there is increased interest in the use of MIGS as a standalone option for pseudophakic eyes with poorly controlled primary open-angle glaucoma,” according to the study authors. This surgical system provides the “potential for additional IOP and medication reduction, especially in eyes that have already experienced the pressure-lowering effects of cataract surgery.”
Disclosure: This research was supported by Sight Sciences, Inc. Multiple study authors declared affiliations with the biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Reference
Bleeker AR, Litchfield WR, Ibach MJ, et al. Short-term efficacy of combined ab interno canaloplasty and trabeculotomy in pseudophakic eyes with open-angle glaucoma. Clin Ophthalmol. 2022;16:2295-2303. Published 2022 Jul 21. doi:10.2147/OPTH.S367896
