Safety And Efficacy Of Ab-Interno Canaloplasty Using The Itrack In Angle Closure Glaucoma: 12-Month Results

To report the safety and efficacy of ab-interno canaloplasty using the iTrack™ device (Nova Eye Medical, Fremont, USA) in patients with primary angle closure glaucoma (PACG).

Data was retrieved from the International Glaucoma Surgery Registry.

A prospective multicenter (Australia, USA, Canada, United Kingdom) case series including 47 eyes of 47 patients with PACG undergoing canaloplasty via an ab-interno technique, with or without cataract extraction. Outcome measures included intraocular pressure (IOP), number of glaucoma medications and adverse events. 12-month results are presented.

Mean IOP (mmHg) and number of medications decreased from 20.9±6.3 and 2.02±1.5 at baseline (n=47) to 13.7±3.5 (p<0.001) and 0.84±1.2 (p<0.001) at 6M (n=32), and to 12.9±3.2 (p<0.001) and 0.59±0.9 (p<0.001), respectively, at 12M (n=22). The 5 eyes operated with canaloplasty as a standalone procedure had baseline IOP of 21.6±6.4 and required 2.40±1.7 medications, which reduced to 14.8±1.8 and 1.00±1.4, respectively, at 6M postoperatively. 21.3% and 46.8% of the eyes had an IOP ≤15mmHg and ≤18mmHg at baseline, respectively, vs 62.5% and 93.8% at 6M postoperatively; 63.6% (14/22) of the eyes were medication-free at 12M from 17.0% (8/47) at baseline. One eye had a hyphema (>10% anterior chamber) that resolved without late sequela.

Canaloplasty, with or without phacoemulsification, performed on PACG eyes resulted in significant IOP and medication reductions, with most eyes medication-free at 12 months.