Abstract
Purpose :
Minimally invasive glaucoma surgery (MIGS) includes a variety of novel techniques to achieve lower intraocular pressure (IOP) in mild to moderate primary open angle glaucoma. The Hydrus Microstent and OMNI Surgical System are two frequently utilized devices. Recently, surgeons have employed the OMNI canaloplasty along with the Hydrus Microstent hoping to achieve additional IOP lowering. The aim of this retrospective study is to evaluate if combining OMNI canaloplasty with Hydrus Microstent improves IOP reduction and decreases drop burden compared to Hydrus alone.
Methods :
This is a single-surgeon, single-center, retrospective chart review study. Data on eyes that underwent cataract surgery with Hydrus Microstenting (n=22) and Hydrus Microstenting with OMNI canaloplasty (n=20) was collected from 2020-2022. This preliminary report includes data analysis up to post-operative month 1 (POM1) given the ongoing nature of this study. Chi-squared and paired t-tests (p=0.05) were utilized.
Results :
25 patients and 42 eyes were enrolled. The average age was 68 ± 7.37 years. 11 (44%) patients were female. 12 (48%) identified at white/Caucasian, 9 (36%) as Hispanic/Latino, 2 (8%) as black/African American, and 2 (8%) as Asian. There was no significant difference in visual acuity at any time point between the Hydrus and Hydrus/OMNI groups. There was no significant difference in pre-operative IOP between the Hydrus (15.4mmHg) and OMNI/Hydrus (14.7mmHg) groups (p=0.512). There was no significant difference in IOP in either group at POM1 compared to the pre-operative IOP. The average percent decrease in IOP at POM1 was 0.015% in the Hydrus group and 0.0017% in the Hydrus/OMNI group. There was a significant difference in the average number of pre-operative IOP lowering agents between Hydrus (n=3) and Hydrus/OMNI (n=2) (p=0.004). At POM1, OMNI patients were on fewer medications (n=0) than Hydrus patients (n=2) (p=0.0002), however both groups experienced a significantly decreased drop burden at POM1 (p=0.0001 for both groups).
Conclusions :
In our preliminary data analysis, the addition of OMNI canaloplasty to Hydrus Microstenting does not result in statistically significant lower IOP compared to the Microstent alone at POM1. Both procedures significantly decrease drop burden at POM1, with the Hydrus/OMNI group achieving a greater drop reduction.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.