Canaloplasty and Trabeculotomy Results in Glaucoma Patients

Studies assessed data registry outcomes using two different devices.

Sarah Atta, MD; Baraa Nawash, MD; Samantha Goldburg, MD; and Mary Qiu, MD

Glaucoma Today

Key Takeaways A prospective, real-world, multicenter study found that ab interno canaloplasty, whether performed alone or in combination with phacoemulsification, had favorable safety and efficacy profiles. A retrospective cohort study found that standalone ab interno canaloplasty and trabeculotomy provided clinically and statistically significant IOP reductions that were sustained through 36 months in patients with primary open-angle glaucoma. A Prospective, Real-World, Multicenter Study to Support the Role of Ab-Interno Canaloplasty in Glaucoma Management Kerr N, Lubeck D, Barton K, et al1 Industry support for this study: Several study authors disclosed consulting relationships with Nova Eye Medical ABSTRACT SUMMARY This prospective, real-world, multicenter study drew on the iTrack Global Data Registry to evaluate ab interno canaloplasty (ABiC) outcomes in 254 patients (344 eyes) with ocular hypertension or open-angle glaucoma (primary or secondary, all severities) over a mean follow-up period of 20.5 months. The study assessed ABiC combined with phacoemulsification and ABiC alone. For combined cases (n = 313 eyes), at the last follow-up visit, the mean IOP had decreased from 17.2 to 14.1 mm Hg, and the mean number of medications had decreased from 2.1 to 1.3 (P < .001). Success was defined using 2024 AAO criteria2 as either a reduction in medication usage of at least one agent without an increase in IOP or at least a 20% decrease in IOP to a level of 21 mm Hg or less without an increase in the number of medications, additional procedures, a loss of light perception, or hypotony. Overall, 61.9% of eyes in the combined group achieved success, and 43% became medication-free (vs 7% preoperatively). For standalone ABiC (n = 24 eyes), mean IOP decreased from 20.2 to 15.3 mm Hg, and the mean number of medications was reduced from 2.3 to 1.5 (P < .01). Success was achieved in 35% of eyes, and 46% became medication-free. IOP and medication reductions were significant across all disease subtypes and severities.

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