Clinical Ophthalmology (Sep 2022)
A Multicenter 12-Month Retrospective Evaluation of Canaloplasty and Trabeculotomy in Patients with Open-Angle Glaucoma: The ROMEO 2 Study
Abstract
James Thomas Murphy III,1 Daniel C Terveen,2 Ardalan E Aminlari,3 Kavita Dhamdhere,4,5 Jaime E Dickerson Jr4,6 On behalf of the ROMEO Study Group1Ophthalmology, Yale New Haven Hospital, New Haven, CT, USA; 2Vance Thompson Vision, Sioux Falls, SD, USA; 3Morris Eye Group, Encinitas, CA, USA; 4Clinical Research, Sight Sciences, Menlo Park, CA, USA; 5Mahatma Gandhi Medical College and Research Center, Wardha, India; 6North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, TX, USACorrespondence: Jaime E Dickerson Jr, Email [email protected]: Twelve-month safety and effectiveness results for canaloplasty combined with trabeculotomy using the OMNI surgical system in pseudophakic eyes or combined with cataract surgery in mild-to-moderate open-angle glaucoma (OAG).Setting: Sixteen centers in 11 US states (AL, AR, CA, CT, KS, LA, MO, NY, SD, TN, TX).Design: Retrospective, case series, open-label.Methods: A total of 136 eligible patients from 20 surgeons: mild-to-moderate OAG (visual field mean deviation (MD) not worse than − 12 dB), 12-month follow-up, preoperative medicated IOP > 18 mmHg and ≤ 36 mmHg on ≤ 5 medications. One eye per patient enrolled. Endpoints included proportion with ≥ 20% reduction in IOP or IOP between 6 and 18 mmHg (inclusive) and on the same or fewer medications without secondary surgical intervention (SSI) (primary success), mean IOP, change in IOP, ocular hypotensive medication use, and proportion of patients with a 20% or greater reduction in IOP at 12 months. Safety: adverse events (AE) and best corrected visual acuity (BCVA).Results: Primary success was met by 71%. Mean IOP was reduced (22.3– 15.9 mmHg, p < 0.0001). Medications went from 1.9 ± 1.3 to 1.3 ± 1.2 (p < 0.001). AE were mild and as expected for angle surgery. The most frequent AE were BCVA loss (6%), mild inflammation (4%), IOP elevation (3%), and clinically significant hyphema (3%). There were 4 (3%) SSI.Conclusion: The OMNI system provides effective IOP reduction, sustained IOP control, and meaningful medication reduction for up to 12 months postoperative. The present study confirms and extends the results from ROMEO.Keywords: viscodilation, MIGS, open-angle glaucoma, glaucoma surgery, canaloplasty, trabeculotomy, OMNI
