Omnitm In Open-Angle Glaucoma Treatment: A 42-Month Interim Follow-Up

This study analyzes clinical outcomes of sequential viscodilation of Schlemm’s canal and collector channels and 360° trabeculotomy as a standalone procedure or combined with cataract surgery in eyes with mild to moderate open-angle glaucoma (OAG).

OMNI 360^TMis a nonperforating surgical procedure for open-angle glaucoma treatment andthe first non-implantable minimally-invasive glaucoma surgery.Using single clear corneal incision viscodilation of Schlemm’s canal and transluminal trabectomy are performed via gonioscopic guidance. It is indicated for the treatment of OAG in adult patients.

In this single-surgeon prospective clinical study carried in Department of Ophthalmology, Centre of Postgraduate Medical Education, Warsaw, Polandthe OMNI glaucoma surgical platform (Sight Sciences, Menlo Park, CA) was utilized to perform the procedure either combined with phacoemulsification or as a standalone procedure. Participating subjects were adults with mild to moderate open-angle glaucoma.Changes from baseline in intraocular pressure (IOP) and IOP-lowering medications were evaluated through the 42-month follow-up period.

Analysis was performed in 22 eyes (20 patients). Mean preoperative IOP was 19,4±4,5 mmHg (n=22). Mean IOP was significantly lower at 12, 24, 36, 42 months postoperatively. The mean IOP was 12,7±1,9 mmHg (p<0,001; n= 15), 12,5±2,1 mmHg (p<0,001; n= 14), 12,2±1,5 mmHg (p<0,001;n=9) and 12,3±3,2 mmHg (p=0,003; n=6), respectively. The final mean IOP reduction was 7,1 mmHg (36,6%). Mean preoperative medications was 2,7±0,7. There was a significant postoperative mean medications reduction through 12, 24, 36 months. The mean medications was 0,6±0,7 (p<0,001; n=15), 1,2±1,2(p=0,001; n=14), 1,3±1,3 (p=0,013; n=9), respectively. 42 months postoperatively the mean medication was 1,6±1,5 (p=0,144; n=6). The final mean drugs reduction was 1,0 (38,8%). 

Viscodilation of Schlemm’s canal and collector channels paired with ab interno trabeculotomy performed with a single integrated instrument (OMNI), whether as standalone or combined with phacoemulsification provided effective IOP reduction, sustained IOP control and meaningful IOP-lowering medication reduction for up to 42 months postoperatively.