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

J Glaucoma. 2023 Sep 12. doi: 10.1097/IJG.0000000000002311. Online ahead of print.


PRCIS: Significant reductions in IOP and number of medications are sustained up to 6 years postoperatively for eyes that underwent ab-interno canaloplasty using the iTrack microcatheter, either as a standalone procedure or combined with cataract surgery.

PURPOSE: To evaluate the long-term effectiveness of iTrack (Nova Eye Medical, Inc.) ab-interno canaloplasty for reducing intraocular pressure (IOP) and number of glaucoma medications in patients with primary open-angle (POAG) and pseudoexfoliative (PEX) glaucoma.

METHODS: A retrospective single-center consecutive case series. Patients were treated with either ab-interno canaloplasty performed as a standalone procedure, or combined with cataract surgery, and were followed for up to 6 years. iTrack was used to circumferentially catheterize and viscodilate Schlemm’s canal over 360°. Primary efficacy endpoints included intraocular pressure (IOP) and number of glaucoma medications at 12, 24, 36, 48, 60, and 72 months after surgery.

RESULTS: 27 eyes of 22 patients, with a mean age of 76.9±6.3 years, were recruited. Mean IOP was reduced significantly from 19.9±5.2 mmHg (n=27) at baseline (no washout) to 14.6±3.3 mmHg at the 6-year follow-up (n=18; P<0.001). The number of medications was significantly reduced from 1.9±1 at baseline to 0.9±0.9 at 6 years (n=18; P=0.005). At all timepoints there was no statistical difference between POAG (n=16) and PEX (n=11) eyes, nor between standalone procedures (n=4) and those combined with phacoemulsification (n=23). At 72 months, the mean reduction in IOP was 27% while 53% in the number of medications. No serious complications were recorded.

CONCLUSION: iTrack ab-interno canaloplasty performed as a standalone procedure, or in combination with cataract surgery, significantly reduced IOP and number of medications in patients with POAG up to 6 years after the procedure. To the authors’ knowledge, this is the longest ab-interno canaloplasty follow-up available in the literature.

PMID:37725787 | DOI:10.1097/IJG.0000000000002311

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