Comparative 12-Month Outcomes Of Phacoemulsification Combined With Omni Canaloplasty-Trabeculotomy In Angle-Closure Versus Open-Angle Glaucoma At A Large Tertiary Glaucoma Referral Centre
Published 2026 - 44th Congress of the ESCRS
Reference: PP04.03 | Type: Free paper | DOI: 10.82333/z3zc-d361
Authors: Ms Tanmayi Amol Chingale* 1 , Mr Tom Ayton 2 , Mr Gerrasimos Lascaratos 3 , Mr Sameer Trikha 2 , Mr Mohammed Abu-Bakra 2 , Ms Madalina Pavel 2 , Mr Avinash Kulkarni 2 , Mr Andrew Swampillai 2 , Mr Obeda Kailani 3
1King’s College London Medical School,London,United Kingdom, 2King’s College Hospital NHS Foundation Trust,London,United Kingdom, 3King’s College London,London,United Kingdom;King's ophthalmology research unit (KORU),London,United Kingdom
Purpose
To compare 12-month clinical outcomes of phacoemulsification combined with OMNI canaloplasty-trabeculotomy in patients with angle-closure glaucoma (PAC/PACG/CACG) versus open-angle glaucoma (OAG) in a tertiary UK centre. As OMNI targets the trabecular and canal-based outflow pathways, its effectiveness may differ between subtypes of glaucoma. Furthermore, OMNI has been predominantly studied in open-angle glaucoma, while evidence in angle-closure disease remains limited. We therefore assessed differences in intraocular pressure reduction and change in glaucoma medication burden between groups.
Setting
Retrospective cohort study conducted at a tertiary UK glaucoma referral centre across two hospital sites.
Methods
We performed a retrospective cohort study of eyes undergoing phacoemulsification combined with OMNI canaloplasty-trabeculotomy at a tertiary UK centre. Eyes with a minimum of 12 months of follow-up were included and stratified by glaucoma subtype (angle-closure [PAC/PACG/CACG] versus OAG). Baseline demographics, preoperative intraocular pressure and medication use were recorded. The primary outcomes monitored were change in intraocular pressure (IOP) and medication use at 12 months. Comparative analyses were performed between groups.
Results
Preliminary analysis included 31 eyes with 12 months postoperative follow up (28 OAG and 3 PACG). The mean preoperative IOP was 20.7 mmHg (20.1 mmHg in OAG and 21.7 mmHg in PACG) reducing to 15.2 mmHg at 12 months (26.6% overall reduction). In the OAG subgroup, mean IOP reduced from 20.1 to 15.5 mmHg (p = 0.002). In the PACG group, mean IOP reduced from 21.7 to 12.3 mmHg. Mean glaucoma medication burden decreased from 2.5 preoperatively (2.1 in OAG and 3.3 in PACG) to 1.7 medications at 12 months (1.5 in OAG and 1.7 in PACG). Medication reduction did not reach statistical significance in the OAG subgroup (p = 0.10). Three eyes required further glaucoma surgery during the follow-up period.
Conclusions
Phacoemulsification combined with OMNI canaloplasty-trabeculotomy demonstrates sustained intraocular pressure and medication reduction at 12 months in this real-world cohort. While reductions were observed in both open-angle and angle-closure subgroups, interpretation of comparative outcomes is limited by the small angle-closure sample size. Ongoing data collection will enable more robust subtype-specific analysis.