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Clinical outcomes of canaloplasty via an ab-interno surgical technique using the iTrack device: a narrative review

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Abstract

Purpose

This narrative review seeks to investigate intraocular pressure (IOP), glaucoma medication dependence and safety profile of canaloplasty performed via an ab-interno surgical technique using the iTrack canaloplasty microcatheter (Nova Eye Medical).

Methods

A literature search was performed in March 2022 using MEDLINE and EMBASE to identify all papers which performed ab-interno canaloplasty using the iTrack, either combined with phacoemulsification or as a standalone procedure in primary open angle glaucoma. IOP was the primary efficacy outcome. Secondary outcomes were glaucoma medication use and safety profile.

Results

The search demonstrated 170 results of which 9 studies were included which totaled 365 eyes. Both IOP and number of medications were reduced at 12–24 months. IOP decreased from 20.0 ± 2.5 mmHg preoperatively to 13.8 ± 0.6 and at 14.0 ± 0.9 at 12 and 24 months; the number of medications was reduced from 2.5 ± 0.5 preoperatively to 0.8 ± 0.4 and 0.9 ± 0.6 at 12 and 24 months postoperatively. Comparable results were observed in the iTrack-alone and iTrack + phaco groups: IOP was reduced from baseline 20.5 ± 1.9 and 19.6 ± 3.0 to 14.3 ± 1.1 and 13.9 ± 1.1 24 months postoperatively respectively.

Conclusion

This review suggests that ab-interno canaloplasty as a standalone procedure or combined with phacoemulsification using the iTrack leads to a reduction in IOP and glaucoma medication use up to 24 months postoperatively.

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References

  1. Quigley HA (2006) The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol 90:262–267. https://doi.org/10.1136/bjo.2005.081224

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Tham Y-CC, Li X, Wong TY et al (2014) Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology 121:2081–2090. https://doi.org/10.1016/j.ophtha.2014.05.013

    Article  PubMed  Google Scholar 

  3. Heijl A, Leske MC, Bengtsson B et al (2002) Reduction of intraocular pressure and glaucoma progression: results from the early manifest glaucoma trial. Arch Ophthalmol 120:1268–1279. https://doi.org/10.1001/archopht.120.10.1268

    Article  PubMed  Google Scholar 

  4. Prum BE, Rosenberg LF, Gedde SJ et al (2016) Primary open-angle glaucoma preferred practice pattern® guidelines. Ophthalmology 123:P41–P111. https://doi.org/10.1016/j.ophtha.2015.10.053

    Article  PubMed  Google Scholar 

  5. Kaur D, Gupta A, Singh G (2012) Perspectives on quality of life in glaucoma. J Curr Glaucoma Pract 6:9–12. https://doi.org/10.5005/jp-journals-10008-1101

    Article  PubMed  PubMed Central  Google Scholar 

  6. Zhang X, Vadoothker S, Munir WM, Saeedi O (2019) Ocular surface disease and glaucoma medications: a clinical approach. Eye Contact Lens 45:11–18. https://doi.org/10.1097/ICL.0000000000000544

    Article  PubMed  PubMed Central  Google Scholar 

  7. Inoue K (2014) Managing adverse effects of glaucoma medications. Clin Ophthalmol 8:903–913. https://doi.org/10.2147/OPTH.S44708

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Vijaya L, Manish P, Ronnie G, Shantha B (2011) Management of complications in glaucoma surgery. Indian J Ophthalmol 59(Suppl):S131–S140. https://doi.org/10.4103/0301-4738.73689

    Article  PubMed  PubMed Central  Google Scholar 

  9. Popovic M, Campos-Moller X, Saheb H, Ahmed IIK (2018) Efficacy and adverse event profile of the iStent and iStent inject trabecular micro-bypass for open-angle glaucoma: a meta-analysis. J Curr Glaucoma Pract 12:67–84. https://doi.org/10.5005/jp-journals-10008-1248

    Article  PubMed  PubMed Central  Google Scholar 

  10. The Royal College of Ophthalmologists College advice on withdrawal of CyPass Micro-Stent by Alcon. Accessed 12 Sep 2021

  11. Nichani P, Popovic MM, Schlenker MB et al (2021) Microinvasive glaucoma surgery: a review of 3476 eyes. Surv Ophthalmol 66:714–742. https://doi.org/10.1016/j.survophthal.2020.09.005

    Article  PubMed  Google Scholar 

  12. Rezkallah A (2019) XEN gel stent a total delayed-onset postoperative hyphema. Int J Ophthalmol 12:1224–1226. https://doi.org/10.18240/ijo.2019.07.27

    Article  PubMed  PubMed Central  Google Scholar 

  13. Sunderland DK, Sapra A (2020) Physiology, Aqueous Humor Circulation. StatPearls

  14. Tektas O-Y, Lütjen-Drecoll E (2009) Structural changes of the trabecular meshwork in different kinds of glaucoma. Exp Eye Res 88:769–775. https://doi.org/10.1016/j.exer.2008.11.025

    Article  CAS  PubMed  Google Scholar 

  15. Allingham RR, de Kater AW, Ethier CR (1996) Schlemm’s canal and primary open angle glaucoma: correlation between Schlemm’s canal dimensions and outflow facility. Exp Eye Res 62:101–110. https://doi.org/10.1006/exer.1996.0012

    Article  CAS  PubMed  Google Scholar 

  16. Andrés-Guerrero V, García-Feijoo J, Konstas AG (2017) Targeting Schlemm’s Canal in the medical therapy of glaucoma: current and future considerations. Adv Ther 34:1049–1069. https://doi.org/10.1007/s12325-017-0513-z

    Article  PubMed  PubMed Central  Google Scholar 

  17. Gong H, Gorantla V, Zhang Y, et al (2015) Morphological changes in the distal outflow pathway of primary open angle glaucoma. In: Annual Meeting of the Association for Research in Vision and Ophthalmology

  18. Stegmann R, Pienaar A, Miller D (1999) Viscocanalostomy for open-angle glaucoma in black African patients. J Cataract Refract Surg 25:316–322. https://doi.org/10.1016/S0886-3350(99)80078-9

    Article  CAS  PubMed  Google Scholar 

  19. Koerber N (2007) Canaloplasty-A new approach to nonpenetrating glaucoma surgery. Tech Ophthalmol 5:102–106. https://doi.org/10.1097/ITO.0b013e3181565083

    Article  Google Scholar 

  20. Lewis RA, von Wolff K, Tetz M et al (2011) Canaloplasty: three-year results of circumferential viscodilation and tensioning of Schlemm canal using a microcatheter to treat open-angle glaucoma. J Cataract Refract Surg 37:682–690. https://doi.org/10.1016/j.jcrs.2010.10.055

    Article  PubMed  Google Scholar 

  21. Hughes T, Traynor M (2020) Clinical results of Ab interno canaloplasty in patients with open-angle glaucoma. Clin Ophthalmol 14:3641–3650. https://doi.org/10.2147/OPTH.S275087

    Article  PubMed  PubMed Central  Google Scholar 

  22. Gallardo MJ (2021) 24-month efficacy of viscodilation of Schlemm’s canal and the distal outflow system with iTrack Ab-interno canaloplasty for the treatment of primary open-angle glaucoma. Clin Ophthalmol 15:1591–1599. https://doi.org/10.2147/OPTH.S272506

    Article  PubMed  PubMed Central  Google Scholar 

  23. Khaimi MA (2021) Long-term medication reduction in controlled glaucoma with iTrack ab-interno canaloplasty as a standalone procedure and combined with cataract surgery. Ther Adv Ophthalmol 13:251584142110457. https://doi.org/10.1177/25158414211045751

    Article  Google Scholar 

  24. Koerber NJ, Ondrejka S (2022) 4-Year Efficacy and Safety of iTrack Ab-interno Canaloplasty as a Standalone Procedure and Combined with Cataract Surgery in Open-Angle Glaucoma. Klin Monbl Augenheilk. Online ahead of print. https://doi.org/10.1055/a-1737-4149

  25. Kazerounian S, Zimbelmann M, Lörtscher M et al (2020) Canaloplasty ab interno (AbiC) – 2-Year-results of a novel minimally invasive glaucoma surgery (migs) technique. Klin Monbl Augenheilk. https://doi.org/10.1055/a-1250-8431

    Article  Google Scholar 

  26. Gillmann K, Aref A, Niegowski LJ, Baumgartner J-M (2021) Combined Ab interno viscocanaloplasty (ABiC) in open-angle glaucoma: 12-month outcomes. Int Ophthalmol 41:3295–3301. https://doi.org/10.1007/s10792-021-01891-1

    Article  PubMed  Google Scholar 

  27. Gallardo MJ, Supnet RA, Ahmed IIK (2018) Viscodilation of Schlemm’s canal for the reduction of IOP via an ab-interno approach. Clin Ophthalmol 12:2149–2155. https://doi.org/10.2147/OPTH.S177597

    Article  PubMed  PubMed Central  Google Scholar 

  28. Koerber N (2017) Canaloplasty ab interno - a minimally invasive alternative. Klin Monbl Augenheilkd 234:991–995. https://doi.org/10.1055/s-0042-123829

    Article  Google Scholar 

  29. Gallardo MJ, Supnet RA, Ahmed IIK (2018) Circumferential viscodilation of Schlemm’s canal for open-angle glaucoma: ab-interno vs ab-externo canaloplasty with tensioning suture. Clin Ophthalmol 12:2493–2498. https://doi.org/10.2147/OPTH.S178962

    Article  PubMed  PubMed Central  Google Scholar 

  30. Gallardo MJ (2022) 36-month effectiveness of ab-interno canaloplasty standalone versus combined with cataract surgery for the treatment of open-angle glaucoma. Ophthalmol Glaucoma. https://doi.org/10.1016/j.ogla.2022.02.007

    Article  PubMed  Google Scholar 

  31. Lavia C, Dallorto L, Maule M et al (2017) Minimally-invasive glaucoma surgeries (MIGS) for open angle glaucoma: a systematic review and meta-analysis. PLoS ONE 12:e0183142. https://doi.org/10.1371/journal.pone.0183142

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Rosdahl JA, Gupta D (2020) Prospective studies of minimally invasive glaucoma surgeries: systematic review and quality assessment. Clin Ophthalmol 14:231–243. https://doi.org/10.2147/OPTH.S239772

    Article  PubMed  PubMed Central  Google Scholar 

  33. Majstruk L, Leray B, Bouillot A et al (2019) Long term effect of phacoemulsification on intraocular pressure in patients with medically controlled primary open-angle glaucoma. BMC Ophthalmol 19:1–7. https://doi.org/10.1186/S12886-019-1157-3

    Article  CAS  Google Scholar 

  34. Shingleton BJ, Pasternack JJ, Hung JW et al (2006) Three and five year changes in intraocular pressures after clear corneal phacoemulsification in open angle glaucoma patients, glaucoma suspects, and normal patients. J Glaucoma 15:494–498. https://doi.org/10.1097/01.ijg.0000212294.31411.92

    Article  PubMed  Google Scholar 

  35. Mathalone N, Hyams M, Neiman S et al (2005) Long-term intraocular pressure control after clear corneal phacoemulsification in glaucoma patients. J Cataract Refract Surg 31:479–483. https://doi.org/10.1016/j.jcrs.2004.06.046

    Article  PubMed  Google Scholar 

  36. Fingeret M, Dickerson JE (2018) The role of minimally invasive glaucoma surgery devices in the management of glaucoma. Optom Vis Sci 95:155–162. https://doi.org/10.1097/OPX.0000000000001173

    Article  PubMed  PubMed Central  Google Scholar 

  37. Wang B, Leng X, An X et al (2020) XEN gel implant with or without phacoemulsification for glaucoma a systematic review and meta-analysis. Ann Trans Med 8:1309–1309. https://doi.org/10.21037/atm-20-6354

    Article  Google Scholar 

  38. Yook E, Vinod K, Panarelli JF (2018) Complications of micro-invasive glaucoma surgery. Curr Opin Ophthalmol 29:147–154. https://doi.org/10.1097/ICU.0000000000000457

    Article  PubMed  Google Scholar 

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Funding

The authors have no financial or proprietary interest in any material or method mentioned. The author (NK) is the Principal Investigator for the Catalyst clinical study which uses the product mentioned in this manuscript (iTrack, Nova Eye Medical).

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Authors and Affiliations

  1. Augencentrum Köln, Josefstraße 14, 51143, Köln, Germany

    Norbert Koerber & Simon Ondrejka

  2. Eye Clinic, University Eye Hospital, Padua, Italy

    Norbert Koerber

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  1. Norbert Koerber
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  2. Simon Ondrejka
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The authors have performed all the research, data analysis, manuscript writing (drafts and revisions).

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Correspondence to Norbert Koerber.

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Koerber, N., Ondrejka, S. Clinical outcomes of canaloplasty via an ab-interno surgical technique using the iTrack device: a narrative review. Int Ophthalmol 43, 2017–2027 (2023). https://doi.org/10.1007/s10792-022-02601-1

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  • DOI: https://doi.org/10.1007/s10792-022-02601-1

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