Abstract
Purpose :
Ab-interno canaloplasty (ABiC) and gonioscopy-assisted transluminal trabeculotomy (GATT) are minimally invasive glaucoma surgery (MIGS) procedures that are both reportedly effective in lowering intraocular pressure (IOP). This non-randomized, single center retrospective case series aimed to contribute to the literature by comparing outcomes when these procedures are performed alone and when combined.
Methods :
This study included patients (mean age 59.3±16.5 years; 30 males, 17 females), mostly with primary open-angle glaucoma, across all glaucoma severities, who were treated with ABiC using the iTrack microcatheter (Nova Eye Medical) as a standalone procedure (“ABiC” group) or combined with GATT (“ABiC+GATT” group). A number of eyes were treated with either ABiC or ABiC+GATT with or without cataract surgery (“ABiC+Phaco”, “GATT+Phaco” and “ABiC+GATT+Phaco” groups). Patients were stratified according to procedure and then according to glaucoma severity. Eyes were followed over a 12-month period. Wilcoxon signed-rank test was used for statistical analysis.
Results :
47 eyes were included. Majority of the eyes (62%) had severe glaucoma. Overall mean baseline IOP (mmHg) was 21.4±10.5 which reduced to 14.5±8.2 and 13.6±5.5 (p<.001) at 3 and 6 months postop, respectively. Mean baseline number of medications was 3±1.4 which reduced to 1.9±1.3 and 1.7±1.5 (p<.001) at 3 and 6 months postop, respectively. The mean cannulation for the ABiC group was 306° (of the total 360°) and 318° for ABiC+GATT. Table 1 reports mean outcomes at baseline, 3 months and 6 months for the respective procedure groups for all eyes; Table 2 for eyes with severe glaucoma. Four eyes (8%) had additional glaucoma surgery (1 diode cyclophotocoagulation, 3 Baerveldt implant). No serious complications were observed but a choroidal detachment at month 4 related to subsequent Baerveldt glaucoma implant rather than the initial GATT surgery.
Conclusions :
ABiC and GATT, whether combined with cataract surgery or not, resulted in a generic reduction in IOP and glaucoma medications.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.