6-Year Clinical Effectiveness Of Ab-Interno Canaloplasty In Reducing The Medication Burden In Glaucoma Patients

To investigate the clinical effectiveness of ab-interno canaloplasty (iTrack, Nova Eye, Inc., Fremont, USA) with or without phacoemulsification in reducing the number of medications in patients with primary open-angle glaucoma (POAG).

Retrospective single-center case series in Augencentrum Köln-Porz, Köln, Germany.

Patients with POAG who had undergone canaloplasty using the iTrack microcatheter via an ab-interno surgical technique (ABiC) with or without phacoemulsification. Primary efficacy endpoints included mean number of glaucoma medications and intraocular pressure (IOP) at 6 years.

Eighteen eyes of 16 patients, with a mean age of 76.6±6.5 years were recruited and followed up for 6 years. No eye was medication free at baseline compared to 7/18 (39%) at 6 years; 7/18 eyes (39%) were on 1 or less medications at baseline compared to 13/18 (72%) 6 years postoperatively. At 6 years, 11 eyes (61%) had reduced the number of medications compared to baseline, 4 eyes (22%) were on the same medications and 3 eyes (16%) were on more medication than at baseline. Mean IOP decreased from 20.9±5.2 to 14.6±3.2 (p<0.001): no eyes had a raised IOP, 2 eyes (11%) had the same IOP and 16 eyes (89%) had reduced IOP. No serious complications were recorded.

Six years postoperatively, ab-interno canaloplasty performed as a standalone procedure or in combination with cataract surgery achieved a reduction in the number of medications in almost all patients, while still achieving a significant IOP reduction.