Ab Interno-Combined Sectorial Canaloplasty And Trabeculotomy
Published 2024 - 42nd Congress of the ESCRS
Reference: PO1041 | Type: Free paper | DOI: 10.82333/jr64-zs85
Authors: Maria Romero* 1 , Aydan Turkay 2 , Aryan Waghmod 2
1Precision Eye Care,Baltimore,United States, 2Johns Hopkins University,Baltimore,United States
Purpose
To evaluate the surgical outcomes of ab-interno combined sectorial canaloplasty and goniotomy combined with cataract surgery and as standalone procedures in patients with mild and moderate primary open angle glaucoma (POAG)
Setting
Private practice in Baltimore,MD US
Design : prospective consecutive surgical series, interventional single arm
Inclusion criteria: patients with POAG on one or more glaucoma eye drops
Exclusion criteria: prior glaucoma surgery, prior ocular surgery other than cataracts, IV injections
Methods
The OMNI surgical system ( Sight Science) was used to performed ab interno viscocadilation and trabeculotomy in 65 eyes across 42 patients. The viscodilation was performed in the inferior 180 degrees and the trabeculotomy was performed only in the inferior nasal quadrant, either or without concurrent cataract surgery.
Glaucoma drops were not discontinue pre-operative.
Primary outcomes: IOP, number of drops for glaucoma
Secondary Outcomes: VA, impact of race and durability of outcomes
Results
The study included 65 eyes (42 pat.) with early and moderate OAG. 64 eyes had POAG, and 1 eye had pigmentary glaucoma.
63% percent of the patients involved were African American
The mean pre-op value was 16.8 mmHg, the mean post-op IOP values were 13.7 mmHg. A mean drop of 3.1 mmHg. The mean number of medications used pre- op was 1.6, the mean post-op were 0.7 with 76 % of eyes able to decrease the number of drops.
The most common complication was increased intraocular inflammation in the post-op period. Patients demonstrating the largest drops in IOP included highest IOP at the starting point. There were no significant differences in patients with or without concurrent cataract surgery. Average follow-up in this series was 31 months
Conclusions
The viscodilation in the inferior 180 degrees with trabeculotomy of the inferior nasal quadrant is effective and safe procedure, allowing the preservation of most of TM tissue that can be targeted, if needed, to reduce IOP in the future. The clinical relevance of this study is that the findings involves real world data compared to controlled clinical trials in a patient population where glaucoma is more resistant to treatment.