gms | German Medical Science

Purpose: To investigate the clinical effectiveness of ab-interno canaloplasty (iTrack, Nova Eye, Inc.) with or without phacoemulsification in reducing the number of medications in patients with primary open-angle glaucoma (POAG).

Methods: This retrospective single-center case series recruited patients with POAG who had undergone canaloplasty using the iTrack microcatheter via an ab-interno surgical technique (ABiC) with or without phacoemulsification. Patients were divided into 5 groups according to the baseline number of medications (0, 1, 2, 3, 4).

Results: 27 eyes of 22 patients (mean age 76.9±6.1 years) were recruited. One eye was medication-free at baseline (IOP=28 mmHg) and did not reach the 5-year follow-up (it was medication-free at 24 months; IOP=16 mmHg). Nine eyes were on 1 medication at baseline and on 1.1±0.9 medications at 60 m (n=7; p=0.6); IOP decreased from 18.8±4.6 to 13.7±2.1. Ten eyes were on 2 medications at baseline and on 1±1.4 medications at 60 m; IOP from 20.1±6.5 to 15.6±4.6 (n=5). Five eyes were on 3 medications at baseline and 1.3±0.6 at 60 m (n=3); IOP from 20.2±4 to 13.7±3.1. Two eyes were on 4 medications at baseline and did not reach the 5-year follow-up (both eyes were medication-free at 36 m).

Conclusion: Five years postoperatively, ABiC performed as a standalone procedure or in combination with cataract surgery achieved a reduction in both the mean number of medications and IOP in patients on 2 or more medications at baseline. In patients on 1 or less medications at baseline the number of medications remained stable while IOP was reduced.