An ab interno canaloplasty, a micro-invasive glaucoma surgical (MIGS) device, effectively reduces intraocular pressure (IOP) and medication dependence with a good safety profile, making it a viable option as a standalone procedure or combined with cataract surgery in all glaucoma severity grades, according to a study published in The Journal of Clinical Ophthalmology.

The retrospective comparative and consecutive case series was developed to evaluate 24-month efficacy of the viscodilation of Schlemm’s canal and the distal outflow system using the device as a standalone procedure (device alone) or combined with cataract surgery (device+phaco). A total of 53 patients (60 eyes) with a mean age of 73.6±9 years with mild, moderate, or severe primary open-angle glaucoma (POAG) were included. At 12- and 24-month follow-up visits, data was collected.

Investigators found that in all eyes, a significant reduction in mean IOP occurred at 12 and 24 months, from 20±4.9 mm Hg at baseline to 13.6±1.9 mm Hg and 13.5±2.6 mm Hg, respectively (P <.001). Medication reduction was also significant, from 1.12±1.09 and 1.7±1.29 medications at 12 months and 24 months, respectively, from a baseline of 2.77±0.91 (P <.001). These results were seen with both a standalone MIGS procedure or combined with cataract surgery.


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While the device alone group started with a higher IOP at baseline, both groups experienced similar and stable IOP reduction of more than 30% from baseline. The reduction in medication use was also significant in both groups, decreasing from 3±0.7 for device alone and 2.5±1.1 for device+phaco at baseline to 2.1±1.3 and 1.3±1.2 at 24 months, respectively (P <.001), according to the researchers.

Both mild/moderate and severe glaucoma had similar efficacy outcomes at 24 months. Serious adverse events were not reported.

The study’s limitations were that it was a single-center, retrospective case series and had a relatively small population cohort.

Disclosure: One study author declared affiliations with the biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. Nova Eye Medical has provided statistical analysis and manuscript preparation support.

Reference

Gallardo MJ. 24-month efficacy of viscodilation of schlemm’s canal and the distal outflow system with iTrack ab-interno canaloplasty for the treatment of primary open-angle glaucoma. Clin Ophthalmol. 2021;15:1591-1599. doi:10.2147/OPTH.S272506