GEMINI Study extension shows sustained efficacy of canaloplasty and trabeculotomy in glaucoma patients

The 36-month extension of the GEMINI study demonstrates the sustained effectiveness of canaloplasty and trabeculotomy, in conjunction with cataract surgery and utilizing the OMNI Surgical System, for managing intraocular pressure (IOP) and reducing the need for ocular hypotensive medications in patients with mild-to-moderate glaucoma.

The study indicates a significant and consistent reduction in mean unmedicated diurnal IOP, a high proportion of eyes with a ≥20% reduction in IOP, and a substantial decrease in the number of IOP-lowering medications.

The GEMINI study initially focused on a 12-month prospective, multicenter investigation, targeting individuals with visually significant cataracts, mild-to-moderate glaucoma, medicated IOP below 33 mmHg, and unmedicated mean diurnal IOP (DIOP) between 21-36 mmHg after washout. The extension included 66 consenting patients from the GEMINI cohort.

Key findings from the 36-month extension revealed a substantial reduction in mean unmedicated DIOP from 23.1 mmHg at baseline to 16.3 mmHg, showcasing mean reductions of 6.9 mmHg. The proportion of eyes with a ≥20% reduction in IOP was 78%, while 74% of patients were medication-free at the end of the study period.

At 36 months, 71% of patients maintained an IOP between 6 and 18 mmHg, and the mean IOP-lowering medication dropped from 1.7 at baseline to 0.3, marking a reduction of 1.4 medications. The data demonstrated the sustained effectiveness of the canaloplasty and trabeculotomy combination, echoing the positive outcomes observed at the 12-month mark in the original GEMINI study.

Reference
Greenwood MD, Yadgarov A, Flowers BE, et al; GEMINI 2 STUDY GROUP. 36-Month Outcomes from the Prospective GEMINI Study: Canaloplasty and Trabeculotomy Combined with Cataract Surgery for Patients with Primary Open-Angle Glaucoma. Clin Ophthalmol. 2023;17:3817-3824. doi: 10.2147/OPTH.S446486. PMID: 38105915; PMCID: PMC10725746.