6-Year Efficacy And Safety Of Itrack Ab-Interno Canaloplasty As A Standalone Procedure And Combined With Cataract Surgery In Primary Open-Angle Glaucoma

To evaluate the long-term effectiveness of iTrack (Nova Eye, Inc., Fremont, USA) ab-interno canaloplasty in reducing intraocular pressure (IOP) and glaucoma medications in patients with primary open-angle (POAG) and pseudoexfoliative (PEX) glaucoma.

Augencentrum Köln-Porz, Köln, Germany 

In this retrospective monocentric consecutive case series, 27 eyes of 22 patients, with a mean age of 77.3±5.8 years were treated with ab-interno canaloplasty performed as a standalone procedure or combined with cataract surgery and followed for up to 6 years (no medications washout). The iTrack was used to circumferentially catheterize and viscodilate Schlemm’s canal over 360°. Primary efficacy endpoints included intraocular pressure (IOP) and number of glaucoma medications at 12-24-36-48-60-72 months after surgery.

Twenty-seven eyes of 22 patients, with a mean age of 76.6±6.5 years were recruited. Mean IOP was statistically significantly reduced from 19.8±5.2mmHg (n=27) at baseline to 14.6±3.3mmHg at the 6-year follow-up (n=18;  p<0.001). The number of glaucoma medications was statistically significantly reduced from 1.9±1.00 at baseline to 0.9±0.9 at 6 years (n=18; p=0.005). At all timepoints there was no statistical difference between POAG (n=16) and PEX (n=11) eyes, nor between standalone (n=4) or combined with phaco (n=23) procedures. At 72 months, the mean percentage reduction in IOP is 26% and in medication is 58%. No serious complications were recorded.

iTrack ab interno canaloplasty performed as a standalone procedure or in combination with cataract surgery significantly reduced IOP and medications in patients with POAG up to 6 years after the procedure. To the authors’ knowledge, this is the longest ab-interno canaloplasty follow up available in the literature.