Purpose To evaluate the effectiveness and safety of ab-interno canaloplasty using the iTrack microcatheter in patients with primary open-angle glaucoma (POAG). Methods This retrospective, single-center case series included eyes with POAG treated with iTrack ab-interno canaloplasty (Nova Eye Medical, USA), performed either as a standalone procedure or combined with phacoemulsification, with a minimum follow-up of 12 months. Primary outcomes were changes in IOP and number of glaucoma medications. Secondary outcomes included visual acuity (VA), visual field (VF) mean deviation (MD), complications, need for additional glaucoma surgery, and surgical success (as defined by American Academy of Ophthalmology [AAO] criteria). Subgroup analyses were conducted based on disease severity, baseline IOP (≤ 18 mmHg vs. > 18 mmHg), and preoperative medication use (0–4). Results Both standalone (n = 167) and combined (n = 364) procedures achieved significant reductions in IOP and medication use (p < 0.001). At the last follow-up (mean: 20.4 ± 7.7 months), mean IOP was reduced by 3.29 ± 6.0 mmHg in the combined group (from 17.5 ± 5.8 to 14.2 ± 3.8 mmHg) and by 4.50 ± 6.1 mmHg in the standalone group (from 20.2 ± 6.0 to 15.7 ± 4.3 mmHg), with the standalone group showing a significantly greater absolute IOP reduction (p = 0.025). Medication burden was reduced by 1.05 ± 1.06 medications in the combined group and by 0.84 ± 1.15 in the standalone group (p = 0.032). Subgroup analyses confirmed significant IOP and/or medication reductions across all strata, with greater relative benefits in eyes with uncontrolled baseline IOP (> 18 mmHg). Surgical success was 64% in combined and 47% in standalone procedures; success was 75% and 46% in eyes with uncontrolled and controlled baseline IOP. Intraoperative complications were infrequent (1.6%), and 13.1% of eyes required additional glaucoma surgery during follow-up. Conclusions Ab-interno canaloplasty using the iTrack microcatheter, whether as a standalone procedure or combined with phacoemulsification, resulted in sustained reductions in IOP and medication use, with a low rate of complications. These outcomes were consistent across varying levels of disease severity and baseline IOP, with the most pronounced benefits observed in eyes with elevated preoperative IOP.

Canaloplasty via an ab-interno approach in primary open-angle glaucoma: Results from a large case series

期刊论文
发表日期：

2026年5月26日

查看全文

Mahmoud A. Khaimi

摘要

Purpose

To evaluate the effectiveness and safety of ab-interno canaloplasty using the iTrack microcatheter in patients with primary open-angle glaucoma (POAG).

Methods

This retrospective, single-center case series included eyes with POAG treated with iTrack ab-interno canaloplasty (Nova Eye Medical, USA), performed either as a standalone procedure or combined with phacoemulsification, with a minimum follow-up of 12 months. Primary outcomes were changes in IOP and number of glaucoma medications. Secondary outcomes included visual acuity (VA), visual field (VF) mean deviation (MD), complications, need for additional glaucoma surgery, and surgical success (as defined by American Academy of Ophthalmology [AAO] criteria). Subgroup analyses were conducted based on disease severity, baseline IOP (≤ 18 mmHg vs. > 18 mmHg), and preoperative medication use (0–4).

Results

Both standalone (n = 167) and combined (n = 364) procedures achieved significant reductions in IOP and medication use (p < 0.001). At the last follow-up (mean: 20.4 ± 7.7 months), mean IOP was reduced by 3.29 ± 6.0 mmHg in the combined group (from 17.5 ± 5.8 to 14.2 ± 3.8 mmHg) and by 4.50 ± 6.1 mmHg in the standalone group (from 20.2 ± 6.0 to 15.7 ± 4.3 mmHg), with the standalone group showing a significantly greater absolute IOP reduction (p = 0.025). Medication burden was reduced by 1.05 ± 1.06 medications in the combined group and by 0.84 ± 1.15 in the standalone group (p = 0.032). Subgroup analyses confirmed significant IOP and/or medication reductions across all strata, with greater relative benefits in eyes with uncontrolled baseline IOP (> 18 mmHg). Surgical success was 64% in combined and 47% in standalone procedures; success was 75% and 46% in eyes with uncontrolled and controlled baseline IOP. Intraoperative complications were infrequent (1.6%), and 13.1% of eyes required additional glaucoma surgery during follow-up.

Conclusions

Ab-interno canaloplasty using the iTrack microcatheter, whether as a standalone procedure or combined with phacoemulsification, resulted in sustained reductions in IOP and medication use, with a low rate of complications. These outcomes were consistent across varying levels of disease severity and baseline IOP, with the most pronounced benefits observed in eyes with elevated preoperative IOP.