Viscocanaloplasty And Trabeculotomy With Omni Device In Patients With Different Types Of Glaucoma – Real World Data

To provide real world data on the efficacy of viscocanaloplasty with trabeculotomy using the OMNI device in patients with open angle glaucoma (OAG), primary angle closure glaucoma (PACG) and normal tension glaucoma (NTG).

Based at the University Hospital Southampton Eye Unit.

79 eyes of 73 patients underwent viscocanaloplasty with trabeculotomy using the OMNI device, either in combination with cataract surgery, or standalone. Success was defined as postoperative intraocular pressure (IOP) between 6 mmHg and 18 mmHg, or at least 20% reduction compared to baseline, on the same or fewer glaucoma medications. Patients with primary angle closure glaucoma were included, provided that at the conclusion of cataract surgery the angle was open and no peripheral anterior synechiae (PAS) were present.

All 79 eyes were included. The rate of success was 82%, 87.5%, 89% and 87% at 1 week, 1 month, 3 months and 6 months postoperatively, respectively. The mean preoperative IOP was 20.2mmHg±4.6 (p<0.001). The mean postoperative IOP was 15.5mmHg±8.4 (p <0.001) at week1, 15.2mmHg±5.3 (p <0.001 at 1month, 14.7mmHg±3.8 (p <0.001) at 3months and 12.9mmHg± 3 (p < 0.004) at 6months. The mean number of medications decreased from 2.46 preoperatively to 1.57, 1.45, 1.25 and 1.85 at 1week, 1month, 3months and 6months postoperatively, respectively. No significant difference in IOP reduction was found between patients who had 360/180 (viscocanaloplasty/trabeculotomy) and 180/180. 3 eyes had hypotonous maculopathy due to cyclodialysis cleft.

Viscocanaloplasty and trabeculotomy using the OMNI device provide significant reduction in IOP and number of hypotensive drops required, when performed in combination with cataract surgery and as a standalone procedure. Despite clinical hypotony being reported, it has an overall good safety profile.