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.

COLLAB CORNER: Takeaways From a Private Practice Owner

Marc R. Bloomenstein, OD, FAAO; and Rachael Wruble, OD, FAAO

Eyetube

Marc Bloomenstein, OD, FAAO, chats with Rachael Wruble, OD, FAAO, who owns a private practice in North Carolina and is cold-starting another. Dr. Wruble says that one of the defining features that makes her practice stand out from others is having up to four ODs with different specialties providing care at any given time, making possible a diverse range of care. Her practice's motto: "If you take care of patients, they'll take care of you." (Dr. Bloomenstein is a consultant for Glaukos. Dr. Wruble has no financial disclosures.)

Influencing Office Culture and Success

Following these four steps enabled me to make a significant impact as a new graduate.

Noa Robson, OD, MBA, FAAO

Modern Optometry