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Ab-interno canaloplasty with the iTrack Advance device safely provides sustained intraocular pressure control and nearly eliminates medication dependence over 24 months in patients with early open-angle glaucoma. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

October 4, 2025Open Access

The Impact of Interventional Glaucoma with and without Cataract Surgery in Early Open-angle Glaucoma: 24-month Results with a New Canaloplasty Device

SOSimon OndrejkaTH Köln - University of Applied Sciences NKNorbert KoerberTH Köln - University of Applied Sciences

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Abstract

Purpose: To investigate outcomes of interventional glaucoma therapy with canaloplasty in early glaucoma.Methods: This retrospective single-center study included patients with mild-to-moderate open-angle glaucoma (OAG) who underwent Ab-interno canaloplasty (ABiC) with iTrack Advance (Nova Eye Medical) with or without combined phacoemulsification.Primary outcomes were intraocular pressure (IOP) and glaucoma medications at 12-, 24-month, and last follow-up (LFU) visits.Secondary outcomes included the proportion of eyes reaching target IOPs, requiring no medications, and achieving success as per American Academy of Ophthalmology (AAO) criteria.Results: Ninety-eight eyes (60 patients, mean age: 71.4 7.0 years) were included, with a mean follow-up of 19.0 5.7 months.Mean IOP (mm Hg) reduced from 18.3 4.3 at baseline (n = 98) to 14.2 3.1 at 12 months (n = 93), 14.1 3.3 at 24 months (n = 67), and 14.6 3.2 at LFU (p < 0.001).Mean medications decreased from 1.9 0.8 at baseline to 0.1 0.5 at both 12 and 24 months, and 0.1 0.4 at LFU, respectively (p < 0.001).At LFU, 89% of eyes achieved IOP 18 mm Hg, while 95% were medication-free compared to none at baseline.Success rates following combined canaloplasty and phacoemulsification (n = 90) and stand-alone canaloplasty (n = 8) were 81% and 50%, respectively.The average visual field mean deviation at baseline was -1.90 2.8 dB, which remained stable at LFU (p = 0.439).The postoperative complication was a transient IOP spike (30 mm Hg) in two eyes.No sight-threatening complications were observed, and no additional glaucoma procedures were required.Conclusion: Interventional treatment with iTrack Advance canaloplasty in early OAG showed high safety and achieved IOP control, with nearelimination of medication dependence sustained over 24 months postoperatively.Clinical significance: iTrack Advance canaloplasty provides sustained IOP control and strong medication reduction in the medium term.

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Ondrejka et al. (Sat,) studied this question.

synapsesocial.com/papers/6a2c92a0f3f18188201eab35 https://doi.org/https://doi.org/10.5005/jp-journals-10078-1488

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