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The following is a summary of “Standalone Canaloplasty and Trabeculotomy Using the OMNI Surgical System in Eyes with Primary Open-Angle Glaucoma: A 36-Month Analysis from the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight),” published in the December 2024 issue of Ophthalmology by Radcliffe et al. 

Researchers conducted a retrospective study to characterize long-term real-world clinical outcomes of standalone canaloplasty and trabeculotomy using the OMNI Surgical System (Sight Sciences) in individuals with primary open-angle glaucoma (POAG).  

They included patients from the IRIS Registry with POAG or ocular hypertension, known laterality, and at least 6 months but up to 36 months of postoperative follow-up after undergoing standalone canaloplasty and trabeculotomy using the OMNI Surgical System (Sight Sciences) from January 1, 2016. Eyes with prior filtration surgery, trabeculoplasty within 90 days of the procedure, or concomitant cataract surgery were excluded. Outcome measures included changes in intraocular pressure (IOP) and glaucoma medication postoperatively.  

The results showed that 230 eyes in 196 patients were analyzed, with most having moderate (40.0%) or severe (41.3%) POAG. Two-thirds (153 of 230) were pseudophakic, and 44.4% of procedures were performed by glaucoma specialists. The mean baseline IOP was 22.1 (6.4) mmHg, which decreased to 15.1–16.7 mmHg over 36 months (P <0.0001 at all time points compared to baseline), with an average reduction of 5.6-7.1 mmHg. The mean number of glaucoma medications at baseline was 2.1 (1.5), decreasing to 1.1-1.8 medication classes over 36 months, with significant reductions up to 18 months (P ≤0.0011) and nonsignificant decreases at 24 and 36 months. Eyes with baseline IOP ≤18 mmHg showed medication reductions through 36 months, while eyes with baseline IOP >18 mmHg had significant IOP reductions over 36 months.  

Investigators concluded the standalone canaloplasty and trabeculotomy resulted in significant and sustained reductions in IOP up to 36 months postoperatively, with long-term medication reductions in eyes with lower baseline IOP and significant IOP reductions in eyes with higher baseline IOP, making standalone OMNI surgery a viable minimally invasive glaucoma surgery (MIGS) option for patients with POAG. 

Source: ajo.com/article/S0002-9394(24)00581-6/abstract