Four-Year Efficacy and Safety of iTrack Ab-interno Canaloplasty as a Standalone Procedure and Combined with Cataract Surgery in Open-Angle Glaucoma

Abstract

Purpose To evaluate the long-term effectiveness of ab-interno canaloplasty (ABiC), performed with the iTrack microcatheter (Nova Eye Medical, Fremont, CA, USA), in reducing intraocular pressure (IOP) as well as the number of required glaucoma medications in patients with open-angle glaucoma (OAG). Methods In this retrospective single-center consecutive case series, 27 eyes of 21 patients (mean age 77.3 ± 5.8 years) were treated with ABiC performed as a standalone procedure or combined with cataract surgery. Patients with uncontrolled IOP OAG or controlled IOP (≤ 18 mmHg) OAG with intolerance to medications or lack of compliance were included. Patients were followed for up to 4 years following the procedure. The iTrack microcatheter was used to perform a 360-degree circumferential intubation and viscodilation of Schlemmʼs canal. Primary efficacy endpoints included IOP and the number of glaucoma medications at 12, 24, 36, and 48 months after surgery. Results In all eyes, mean IOP and number of glaucoma medications were significantly reduced from 19.8 ± 5.2 mmHg and 1.9 ± 1.00 at baseline to 14.6 ± 3 mmHg and 0.9 ± 0.8, respectively, at the 48-month follow-up (p < 0.001). IOP was stable from 12 months to 48 months (p > 0.005). After 48 months, 39% of the eyes required zero medications compared to 3.7% at baseline, and 72.2% of eyes required only one medication or less. Of all eyes, 77.8% recorded an IOP ≤ 17 mmHg. No serious complications were recorded. Conclusion iTrack ABiC performed as a standalone procedure or in combination with cataract surgery significantly reduced IOP and number of medications in patients with OAG up to 4 years after the procedure.

Canaloplasty in the spotlight: surgical alternatives and future perspectives

“…There is a lot to consider when choosing the appropriate modification of canaloplasty, such as surgical experience, affordability, availability of surgical instrumentation and available data that support surgical success. Although there are a lot of studies that show short-term success, there are less studies available presenting mid-term results [ 17 , 45 , 63 , 64 ] and almost no data is available on long-term outcomes. Further studies are needed to offer a better understanding of these procedures and to determine if ab-externo techniques achieve a better IOP reduction.…”

6-Year Efficacy and Safety of iTrack Ab-Interno Canaloplasty as a Stand-Alone Procedure and Combined With Cataract Surgery in Primary Open Angle and Pseudoexfoliative Glaucoma

“…The results of the same cohort were published at the end of the 4-year follow-up. 7 In this manuscript, the results of the 6-year follow-up of this cohort are presented.…”

“…A full description of the surgical procedure is available in our previous study (4-year results 7 ) and in the scientific literature. 8,9 Outcomes The primary outcomes were IOP and the number of glaucoma medications.…”

“…The longest available follow-up period for patients treated with ab-interno canaloplasty is currently 4 years and was published by our group. 7 In this retrospective study, we report the 6-year outcomes of the same cohort of eyes in which we performed canaloplasty via an ABiC using the iTrack microcatheter (Nova Eye Medical Inc.). To the authors' knowledge, this is the longest ab-interno canaloplasty follow-up available in the literature.…”

„Minimally invasive glaucoma surgery“ – Kammerwinkelbasierte Verfahren im Vergleich

“…Bei-deUnterschiedewarenstatistischnichtsignifikant. Vergleichbare Ergebnisse werden auch von anderen Autoren berichtet [30,32]. Im Vergleich zur Ab-externo-Varian-te liegen damit der drucksenkende Effekt als auch die Reduktion der notwendigen Medikamente im vergleichbaren Niveau der klassischen Ab-externo-Kanaloplastik ohne Modifikation [31].…”