Clinical Ophthalmology (Jul 2022)

Short-Term Efficacy of Combined ab Interno Canaloplasty and Trabeculotomy in Pseudophakic Eyes with Open-Angle Glaucoma

  • Bleeker AR,
  • Litchfield WR,
  • Ibach MJ,
  • Greenwood MD,
  • Ristvedt D,
  • Berdahl JP,
  • Terveen DC

Journal volume & issue
Vol. Volume 16
pp. 2295 – 2303

Abstract

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Adam R Bleeker,1 William R Litchfield,2 Mitch J Ibach,3 Michael D Greenwood,4 Deborah Ristvedt,5 John P Berdahl,3 Daniel C Terveen3 1Dean McGee Eye Institute, Oklahoma City, OK, USA; 2University of North Dakota School of Medicine, Grand Fords, ND, USA; 3Vance Thompson Vision, Sioux Falls, SD, USA; 4Vance Thompson Vision, West Fargo, ND, USA; 5Vance Thompson Vision, Alexandria, MN, USACorrespondence: Adam R Bleeker, Dean McGee Eye Institute – Oklahoma Health Center, 608 Stanton L Young Blvd, Oklahoma City, OK, 73104, USA, Tel +1 605-630-9023, Email [email protected]: To evaluate short-term outcomes of combined ab interno canaloplasty and trabeculotomy in pseudophakic eyes with open-angle glaucoma.Patients and Methods: Series included all pseudophakic eyes with open-angle glaucoma treated with up to 360° ab interno canaloplasty and up to 360° ab interno trabeculotomy using a purpose-engineered device (OMNI, Sight Sciences Inc). Data collected prior to surgery and out to 6-months postoperative. Surgical success defined as a 20% reduction in intraocular pressure (IOP) without increase in glaucoma medication, or discontinuation of at least one glaucoma medication without increase in IOP. Other primary endpoints included mean IOP and number of glaucoma medications.Results: The study included 67 eyes of 52 patients with a mean age of 76.5 ± 8.9 years. Preoperative mean IOP was 22.1± 8.0 mmHg on 2.3± 1.4 glaucoma medications. Pressure lowering effects were sustained out to 6 months postoperative with a mean IOP of 15.2± 4.9 mmHg (p < 0.001) and mean medication reduction of 0.7± 1.4 (p < 0.001). Surgical success rate was 69.8% (30 eyes) and correlated with preoperative IOP. Two patients required a secondary surgical intervention.Conclusion: Combined ab interno canaloplasty and trabeculotomy as a standalone procedure is an effective means of reducing IOP and medication burden in pseudophakic eyes with open-angle glaucoma.Keywords: glaucoma, pseudophakia, MIGS, Schlemm canal

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