Minimally Invasive Glaucoma Surgery System Keeps IOP Low and Steady at 1 Year

A MIGS procedure can effectively keep IOP and the need for medication low for up to 12 months.

In patients with mild to moderate open-angle glaucoma (OAG), the OMNI® surgical system (OSS, Sight Sciences Inc.) can effectively lower intraocular pressure (IOP), sustain IOP control, and provide a meaningful reduction of medication for up to 12 months after surgery, according to a retrospective case series published in Clinical Ophthalmology

The researchers sought to analyze the 12-month safety and efficacy results for canaloplasty combined with trabeculotomy utilizing the OMNI surgical system in pseudophakic eyes or combined with cataract surgery in patients with mild-to-moderate OAG. The analysis included a total of 136 eyes from 136 eligible patients (mean age: 73.8 years, 56% women, 89% with a diagnosis of primary OAG). The team enrolled a single eye from each patient. 

The study authors defined primary success as the percentage of patients at 12 months with an IOP between 6 and 18 mm Hg (inclusive) or with a 20% or more reduction from preoperative baseline IOP and no increase in ocular hypotensive medications and with no further secondary surgical intervention for IOP control. 

A further potential advantage of these modalities is a theoretically continuous and predictable effect on IOP, in contrast to topical drug treatment, where even when administered optimally, there is a peak and trough effect.

Primary success was achieved by 71% of the patients, the report shows. The mean IOP decreased (22.3–15.9 mm Hg, P <.0001) and medications went from 1.9±1.3 to 1.3±1.2 (P <.001). 

The researchers reported that adverse events (AE) were mild and as expected in angle surgery. The most common AE was best corrected visual acuity (BCVA) loss (6%), mild inflammation (4%), IOP elevation (3%), and clinically significant hyphema (3%). Among the cohort, there were 4 (3%) secondary surgical interventions. 

“Sustained release drugs, laser trabeculoplasty and microinvasive glaucoma surgery (MIGS) are all therapeutic options that aim to provide IOP control that is not reliant on patient behavior,” the researchers explain. “A further potential advantage of these modalities is a theoretically continuous and predictable effect on IOP, in contrast to topical drug treatment, where even when administered optimally, there is a peak and trough effect. Fluctuation in IOP has been shown to be a significant independent risk factor for progression of glaucoma.”

This study was limited by the relatively short follow-up period. 

Disclosure: This research was supported by Sight Sciences Inc. Multiple study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.  

References:

Murphy III JT, Terveen DC, Aminlari AE, Dhamdhere K, Dickerson Jr JE. A multicenter 12-month retrospective evaluation of canaloplasty and trabeculotomy in patients with open-angle glaucoma: the ROMEO 2 study. Clin Ophthalmol. Published online September 14, 2022. doi:10.2147/OPTH.S384105