Journal of current glaucoma practice · 2025
The Impact of Interventional Glaucoma with and without Cataract Surgery in Early Open-angle Glaucoma: 24-month Results with a New Canaloplasty Device.
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Ondrejka Simon, Koerber Norbert
Аннотация
PURPOSE: To investigate outcomes of interventional glaucoma therapy with canaloplasty in early glaucoma.
METHODS: 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.
RESULTS: Ninety-eight eyes (60 patients, mean age: 71.4 ± 7.0 years) were included, with a mean follow-up of 19.0 ± 5.7 months. 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 rates following combined canaloplasty and phacoemulsification (n = 90) and stand-alone canaloplasty (n = 8) were 81% and 50%, respectively. The average visual field mean deviation at baseline was -1.90 ± 2.8 dB, which remained stable at LFU (p = 0.439). The postoperative complication was a transient IOP spike (≥30 mm Hg) in two eyes. No sight-threatening complications were observed, and no additional glaucoma procedures were required.
CONCLUSION: 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.
CLINICAL SIGNIFICANCE: iTrack Advance canaloplasty provides sustained IOP control and strong medication reduction in the medium term.
HOW TO CITE THIS ARTICLE: Ondrejka S, Koerber N. The Impact of Interventional Glaucoma with and without Cataract Surgery in Early Open-angle Glaucoma: 24-month Results with a New Canaloplasty Device. J Curr Glaucoma Pract 2025;19(3):112-118.
METHODS: 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.
RESULTS: Ninety-eight eyes (60 patients, mean age: 71.4 ± 7.0 years) were included, with a mean follow-up of 19.0 ± 5.7 months. 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 rates following combined canaloplasty and phacoemulsification (n = 90) and stand-alone canaloplasty (n = 8) were 81% and 50%, respectively. The average visual field mean deviation at baseline was -1.90 ± 2.8 dB, which remained stable at LFU (p = 0.439). The postoperative complication was a transient IOP spike (≥30 mm Hg) in two eyes. No sight-threatening complications were observed, and no additional glaucoma procedures were required.
CONCLUSION: 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.
CLINICAL SIGNIFICANCE: iTrack Advance canaloplasty provides sustained IOP control and strong medication reduction in the medium term.
HOW TO CITE THIS ARTICLE: Ondrejka S, Koerber N. The Impact of Interventional Glaucoma with and without Cataract Surgery in Early Open-angle Glaucoma: 24-month Results with a New Canaloplasty Device. J Curr Glaucoma Pract 2025;19(3):112-118.