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.

Genetic Testing in Clinical Medicine and Eye Care

Follow these five steps to implement this important service in practice.

Miranda Geisinger, OD, FAAO, Chawan Rasheed, OD

Modern Optometry

A Potential Digital Co-Pilot in the Retina OR

AI systems may one day augment traditional surgical workflows to improve efficiency and patient outcomes.

Stanley Poh, MBBS, MMed (Ophth), FRCOphth, FAMS, and Daniel Ting, MD, PhD

Retina Today

KEY TAKEAWAYS By analyzing large volumes of data, AI could generate clinically meaningful insights to enable more informed decision making in the OR. AI could identify high-risk cases and flag factors such as suboptimal glycemic control, anticoagulant use, medical comorbidities, drug allergies, and mobility limitations. Agentic AI can act as a digital co-pilot by integrating preoperative, intraoperative, and postoperative capabilities. Vitreoretinal surgery is a complex discipline involving intricate and highly variable pathology. Many decisions depend on dynamic changes in anatomy and tissue behavior, surgical visualization, and potential complications. As such, vitreoretinal fellows face a steep learning curve. Years of training through residency, fellowship, and independent surgical practice are required to develop the judgement needed to determine whether surgery is warranted, which intervention is most appropriate, and how urgently it should be performed. As AI tools proliferate and improve, they could advance the evolution of the retina OR. By analyzing large volumes of clinical, imaging, and procedural data, AI could generate timely, clinically meaningful insights to enable more informed decision making across preoperative, intraoperative, and postoperative phases of care (Figure). In many ORs, digital visualization systems and intraoperative OCT have already broadened what surgeons can see and have influenced surgical decision making.