ESCRS - PP04.01 - Multicenter Study Comparing Ab-Interno Canaloplasty And Trabecular Micro-Bypass Stent In Primary Open-Angle Glaucoma

Multicenter Study Comparing Ab-Interno Canaloplasty And Trabecular Micro-Bypass Stent In Primary Open-Angle Glaucoma

Published 2026 - 44th Congress of the ESCRS

Reference: PP04.01 | Type: Free paper | DOI: 10.82333/66cx-fv81

Authors: Prof. Keith Barton* 1 , Nathan Kerr 2 , Shamil Patel 3 , David Lubeck 4

1Moorfields,London,United Kingdom, 2Dr Nathan Kerr Eye Surgery Associates,Melbourne,Australia, 3Eye Physicians & Surgeons of Arizona,Arizona,United States, 4Lubeck, David, M.D. Center for Minimally Invasive Surgery,Melbourne,Australia

Purpose

To compare canaloplasty and trabecular micro-bypass surgery outcomes in primary open-angle glaucoma (POAG).

Setting

Ambispective study using data from the International Glaucoma Surgery Registry 

Methods

Ambispective study using data from the International Glaucoma Surgery Registry (IGSR) to evaluate mild-to-moderate POAG patients who underwent iTrack ab-interno canaloplasty (Nova Eye Medical, USA) (prospective cohort) or iStent trabecular micro-bypass implantation (Glaukos, USA) (retrospective cohort), with or without concomitant phacoemulsification, and ≥12 months of follow-up. Primary outcomes were intraocular pressure (IOP), medication usage, and surgical success as defined by the American Academy of Ophthalmology (2024).

Results

The study included 339 eyes (iStent: n=115; iTrack: n=224) of which 94% underwent concomitant phacoemulsification (iStent: n=109, iTrack: n=210).There were nonsignificant differences in baseline IOP (p=0.417) and medications (p=0.741) between groups. At last follow-up, mean IOP (mmHg) and medication usage decreased from 17.3±4.2 and 2.0±1.1 at baseline to 14.2±3.5 and 1.3±1.1 in the iStent group (p<0.001; mean follow-up: 27.2±14.5 months), and from 16.9±5.0 and 2.0±1.1 at baseline to 14.3±3.4 and 1.1±1.3 in the iTrack group (p<0.001; mean follow-up: 20.3±7.7 months). Both groups showed no significant differences in reduction of IOP (p=0.422) and medications (p=0.211). 

Conclusions

In POAG, iTrack canaloplasty and iStent implantation showed no statistically significant differences in effectiveness outcomes. Both procedures had favorable safety profiles with limited additional glaucoma surgeries. More canaloplasty eyes were medication-free compared to stent eyes.