ESCRS - FP03.08 - Tertiary Centre Early Clinical Outcomes And Associated Complications Of Ab-Interno Omni Viscocanaloplasty And Trabeculotomy Combined In Patients With Mild To Advanced Open-Angle Glaucoma.

Tertiary Centre Early Clinical Outcomes And Associated Complications Of Ab-Interno Omni Viscocanaloplasty And Trabeculotomy Combined In Patients With Mild To Advanced Open-Angle Glaucoma.

Published 2024 - 42nd Congress of the ESCRS

Reference: FP03.08 | Type: Free paper | DOI: 10.82333/8txv-6k20

Authors: Madalina Pavel* 1 , Yazan Shabaneh Tammimi 1 , Mohammed Abu-Bakra 2 , Gerassimos Lascaratos 2 , Avinash Kulkarni 1 , Obeda Kailani 2

1Ophthalmology,King’s College Hospital NHS Foundation Trust,London,United Kingdom, 2Ophthalmology,King’s College Hospital NHS Foundation Trust,London,United Kingdom;Ophthalmology,School of Life Sciences, King’s College London,London,United Kingdom

Purpose

This prospective study reports on the safety and efficacy of gonioscopically guided OMNI (viscocanaloplasty and trabeculotomy) in eyes with coexisting cataract as a combined procedure, or pseudophakic eyes as a standalone procedure in medically controlled/ uncontrolled mild, moderate, or advanced open-angle glaucoma.

 

Setting

6 glaucoma surgeons performing combined or standalone OMNI, located in 1 tertiary referral clinical centre (King’s College Hospital NHS Trust) at 2 surgical sites.

 

Methods

Prospective review of eyes treated from August 2023 through 2024, stratified by pre-operative /post-operative intraocular pressure (IOP); ≤15mmHg (Group 1), >15 - < 21mmHg (Group 2), ≥21mmHg (Group 3). Outcome measures were IOP, number of IOP lowering medications, changes in number of medications, endothelial cell loss (ECC loss),  proportion of patients with a > 20% reduction in IOP, and proportion of medication-free patients. Safety outcome data included adverse events (AE) and need for further laser/ surgical interventions.

Results

Study included 67 eyes of 59 patients with a 6-month follow-up. Overall 1-year IOP was 15.9 (-5.7 mmHg, -25% from baseline) with 1.3 medications (-1.1,– 42%). Group 1 (combined cataract surgery) saw 14% IOP reduction, 1.6 medications, and 9.7% ECC loss. Group 1 (standalone) had 32% IOP reduction, 1.4 medications, and 4.7% ECC loss. Group 2 (cataract surgery) had 15.7% IOP reduction, 1.2 medications, and 9.9% ECC loss. Group 2 (standalone) experienced 16.7%IOP reduction, 1.1 medications, and 3.9% ECC loss. Group 3 (cataract surgery) showed 35% IOP reduction, 1.5 medications, and 11.5% ECC loss. Group 3 (standalone) had 27%IOP reduction, 1.2 medications, and 4.1% ECC loss. Primary success observed: 71%(Group 1), 69%(Group 2),and 75%(Group 3).

Conclusions

OMNI viscocanaloplasty and trabeculotomy provides effective and sustainable IOP control with adequate medication reduction for up to 12 months postoperatively.  Longer-term data is needed to establish prologued efficacy of the OMNI.