Ab Interno Canaloplasty - Modern Minimally Invasive Glaucoma Surgery - 18 Months Of Follow-Up
Published 2024 - 42nd Congress of the ESCRS
Reference: PO1067 | Type: Poster | DOI: 10.82333/ph8e-ns71
Authors: Wojciech Maruszczyk* 1 , Łukasz Drzyzga 1 , Dominik Dygas 1 , Michał Bogocz 2 , Marta Swierczynska 2 , Katarzyna Gontarz 2 , Michalina Galuszka 2 , Aleksandra Bukowska 1 , Mariola Dorecka 2 , Ewa Mrukwa-Kominek 2 , Dorota Wygledowska-Promienska 2
1Department of Ophthalmology,Prof. K. Gibinski University Clinical Center, Medical University of Silesia in Katowice,Katowice,Poland, 2Department of Ophthalmology,Prof. K. Gibinski University Clinical Center, Medical University of Silesia in Katowice,Katowice,Poland;Department of Ophthalmology,Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice,Katowice,Poland
Purpose
Canaloplasty is minimally invasive glaucoma surgery procedure (MIGS). There are many modifications, including the ab interno and ab externo access. The procedure purpose is to improve the natural outflow of aqueous humor through the Schlemm's canal. After intervention hypotony can be avoided since aqueous is allowed to drain via the physiological outflow system. The aim of the study is to evaluate the efficacy and safety of ABiC for the treatment of open angle glaucoma in various patients in 18 month follow-up period. We have expanded the scope of the study evaluating OCT (RNFL and GCC).
Setting
Department of Ophthalmology, Prof. K. Gibinski University Clinical Centre, Medical University of Silesia in Katowice, Katowice – Poland
Methods
Patients with diagnosed glaucoma and insufficiently regulated intraocular pressure despite maximally tolerable antiglaucoma medications were selected to the study. We included 52 adult patients with various open angle glaucoma subtypes. All of them underwent ABiC procedure between 2017 to 2022 and had at least 18-months of follow-up period. Patients were treated with the modern ab-interno surgical technique using the iTrack canaloplasty microcatheter (Nova Eye Medical). Patients with 360-degree successful catheterization only were selected for this study. After the procedure we assessed the post-operative IOP, BCVA, OCT, the number of adverse events and complications and the number of antiglaucoma medications.
Results
After the procedure the IOP reduction and stabilisation was observed. The mean IOP was 23.31±9.10mmHg, 15.41±5.49 mmHg, 16.41±4.36 mmHg, 16.89±3.51 mmHg, 16.6±3.56 mmHg, 15.35±3.87 and 15.46±2.60 mmHg before, 1 day, 1, 3, 6, 12, 18 months after the surgery, respectively. The mean usage of the anti-glaucoma topical medications was 2.6±1.07, 1.19±1.27, 1.93±1.10, 1.74±1.10, 1.83±1.34, 1.85±1.14 and 2.23±1.24, before, 1 day, 1, 3, 6, 12 and 18 months after the surgery, respectively. There were no significant changes observed in the GCC and RNFL. No decrease in BCVA and no severe complications were observed. Some of the patients after the surgery were qualified for another antiglaucoma surgery due to insufficient intraocular pressure reduction.
Conclusions
Ab-interno canaloplasty appears to be a safe and effective treatment for glaucoma in all stages of the disease, although further studies are required to assess the long-term effect and late postoperative complication rate. In RNFL thickness and GCC there were no significant alterations observed. Comprehending the significance of this procedure is paramount for refining surgical outcomes and augmenting patient contentment in glaucoma management.