Efficacy And Safety Of Ab-Interno Canaloplasty Using Itrack Advance In Open-Angle Glaucoma

To investigate outcomes of interventional glaucoma therapy with canaloplasty in early glaucoma.

Retrospective single-center study 

This retrospective single-center study included patients with mild-to-moderate open-angle glaucoma (OAG) who underwent Ab-interno canaloplasty (ABiC) with iTrack Advance (Nova Eye Medical) with or without combined phacoemulsification. Primary outcomes were intraocular pressure (IOP) and glaucoma medications at 12-, 24-month, and last follow-up (LFU) visits. Secondary outcomes included the proportion of eyes reaching target IOPs, requiring no medications, and achieving success as per American Academy of Ophthalmology (AAO) criteria.

Ninety-eight eyes (mean age: 71.4±7.0 years) were included, with a mean follow-up of 19.0±5.7 months (LFU). Mean IOP (mm Hg) reduced from 18.3±4.3 at baseline (n = 98) to 14.2±3.1 at 12 months (n = 93), 14.1±3.3 at 24 months (n = 67), and 14.6±3.2 at LFU (p < 0.001). Mean medications decreased from 1.9±0.8 at baseline to 0.1±0.5 at both 12 and 24 months, and 0.1±0.4 at LFU, respectively (p < 0.001). At LFU, 89% of eyes achieved IOP ≤ 18 mm Hg, while 95% were medication-free compared to none at baseline. Success rate of combined canaloplasty and phacoemulsification was 81%. Postoperative complication was a transient IOP spike (≥30 mm Hg) in two eyes. No sight-threatening complications observed, and no additional glaucoma procedures required.

Interventional treatment with iTrack Advance canaloplasty in early OAG showed high safety and achieved IOP control, with near-elimination of medication dependence sustained over 24 months postoperatively