36-Month Effectiveness of Ab-Interno Canaloplasty Standalone versus Combined with Cataract Surgery for the Treatment of Open-Angle Glaucoma.

PURPOSE

To report the 36-month effectiveness of ab-interno canaloplasty performed with the iTrack microcatheter (Nova Eye Medical) as a standalone procedure or combined with cataract surgery.

DESIGN

A single-center, retrospective case series.

PARTICIPANTS

Eyes diagnosed with primary open-angle glaucoma (POAG).

METHODS

Eyes with POAG were treated with either ab-interno canaloplasty as a standalone procedure (iTrack alone) or in conjunction with phacoemulsification (iTrack+phaco).

MAIN OUTCOME MEASURES

The main outcomes were mean reductions in intraocular pressure (IOP) and numbers of glaucoma medications at 12, 24, and 36 months postoperatively. The secondary endpoints consisted of visual acuity and the rate of complications.

RESULTS

Forty-four eyes of 44 patients with open-angle glaucoma were included: 23 eyes in the iTrack-alone group and 21 eyes in the iTrack+phaco group. When both groups were analyzed together, both the IOPs and numbers of medications were significantly reduced at 12 months (P < 0.0001) and remained stable at 24 and 36 months. IOPs decreased from 20.5 ± 5.1 mmHg preoperatively to 13.3 ± 2.1, 13.1 ± 2.4, and 13.3 ± 2.1 mmHg at 12, 24, and 36 months, respectively; the numbers of medications were reduced from 2.8 ± 0.9 preoperatively to 1.1 ± 1.1, 1.0 ± 1.1, and 1.3 ± 1.3 at 12, 24, and 36 months postoperatively, respectively. Comparable IOP results were observed in the iTrack-alone and iTrack+phaco groups, from baseline values 20.9 ± 6.1 and 20.0 ± 3.9 mmHg, respectively, to 13.2 ± 2.1 and 13.5 ± 2.2 mmHg at 36 months, respectively. At 36 months, 95.5% of eyes had an IOP of ≤ 17 mmHg and 68.2% of eyes were on ≤ 1 medication. No serious intraoperative or postoperative complications were reported.

CONCLUSIONS

Ab-interno canaloplasty performed with the iTrack microcatheter was found to be effective in reducing IOP and medication dependence. Comparable results were observed when employed as a standalone procedure or when combined with cataract surgery.