Safety And Efficacy Of Phacoemulsification With Combined Canaloplasty And Trabeculotomy In Severe Primary Open Angle Glaucoma

To assess safety and efficacy outcomes of phacoemulsification with combined canaloplasty and trabeculotomy performed with the OMNI Surgical System (Phaco+OMNI) in the treatment of severe primary open angle glaucoma (POAG).

This was a retrospective, single-surgeon, noncomparative study performed at a tertiary hospital setting. 

18 eyes with severe POAG (mean age 72.0 ± 7.5 years) receiving Phaco+OMNI between April and November 2021 were included in this study. The intraocular pressure (IOP), number of glaucoma medications taken, and best corrected visual acuity (BCVA) were recorded at each time point. Primary study outcomes included changes from baseline in mean IOP and mean number of glaucoma medications through 6 months of follow-up, evaluated using paired sample t-tests. Secondary study outcomes included the percentage of eyes achieving reduction by >1 medication, an IOP < 14 mmHg, and/or 20% IOP reduction from baseline at 6 months.

At 3 months, IOP was reduced from 15.6 ± 5.4 mmHg to 14.1 ± 3.6 mmHg (-9.6%; p=0.26) and number of medications was reduced from 1.4 ± 0.5 to 0.6 ± 0.5 (-55%; p<0.05). At 6 months, IOP was reduced from 15.3 ± 4.5 mmHg to 12.4 ± 2.8 mmHg (-19%; p<0.05) and number of medications was reduced from 1.4 ± 0.4 to 0.4 ± 0.5 (-72%; p<0.05). Reduction by >1 medication, an IOP <14 mmHg, and 20% IOP reduction from baseline were achieved in 76.9%, 84.6%, and 69.2% of eyes, respectively. No vision-threatening complications or adverse effects were observed throughout the follow-up period.

For up to 6 months, Phaco+OMNI demonstrates excellent safety and efficacy in the treatment of eyes with severe POAG.