Clinical Ophthalmology (Jun 2024)
Comparison of Superior versus Inferior Canaloplasty and Trabeculotomy Using the OMNI Surgical System
Abstract
Stephanie H Noh,1– 3 Andrew K Smith,1– 3 Austin R Fox,1– 3 Kevin M Gustafson,1– 3 Changyow C Kwan,1– 3 Ken Y Lin,1,2,4 Sameh Mosaed1,2 1University of California, Irvine School of Medicine, Irvine, CA, 92617, USA; 2Gavin Herbert Eye Institute, Department of Ophthalmology, UC Irvine, Irvine, CA, 92617, USA; 3Tibor Rubin Veteran Affairs Medical Center, Long Beach, CA, 90822, USA; 4Department of Biomedical Engineering, UC Irvine, Irvine, CA, 92617, USACorrespondence: Stephanie H Noh, Gavin Herbert Eye Institute, University of California, Irvine, USA, 850 Health Sciences Road, Irvine, CA, 92617, USA, Tel +1-951-751-7971, Fax +1-949-824-2073, Email [email protected]: To compare outcomes of ab-interno canaloplasty and trabeculotomy of the superior versus inferior angle.Patients and methods: This was a prospective, non-randomized, interventional comparison study done at the Veteran Affairs Hospital in Long Beach, California. All patients underwent cataract surgery with intraocular lens implantation combined with ab-interno canaloplasty and trabeculotomy with the OMNI Surgical System (SightSciences, Menlo Park, CA, USA), either superiorly or inferiorly. Pre- and post-operative intraocular pressure using Goldmann applanation tonometry and best corrected visual acuity were obtained and compared using paired t-tests. Patients were excluded if they had any prior intraocular surgery or prior laser trabeculoplasty procedures.Results: 38 eyes from 29 patients were analyzed. 19 eyes were included in the superior group and 19 eyes in the inferior group. Mean pre-operative IOP in the superior group was 17.6 ± 5.2 mmHg and in the inferior group was 17.6 ± 4.6 mmHg (p > 0.99). At 12 months, mean postoperative IOP for the superior group decreased 24% to 13.3 ± 2.8 mmHg while the inferior group decreased 26% to 13.1 ± 2.2 mmHg (p = 0.92). Mean preoperative medications in the superior group were 2.2 ± 1.3 and in the inferior group was 2.4 ± 1.3 (p = 0.88). At 12 months, this decreased to 1.3 ± 1.5 post-operatively in the superior group and 2.2 ± 1.6 post-operatively in the inferior group (p = 0.64).Conclusion: There was no statistical difference in efficacy between superior versus inferior canaloplasty/trabeculotomy with OMNI. Therefore, surgeons can perform the procedure in the direction that is most comfortable for them without affecting outcomes.Keywords: OMNI, canaloplasty, trabeculotomy, goniotomy, MIGS
