Canaloplasty and microstent combination shows sustained IOP reduction

Combining ab-interno canaloplasty with a microtrabecular bypass stent after cataract surgery effectively lowers intraocular pressure (IOP) and reduces the need for medications in patients with primary open-angle glaucoma (POAG), according to a study.

The retrospective study evaluated the effectiveness of combining ab-interno canaloplasty using the iTrack device with microtrabecular bypass stent surgery (Hydrus microstent) following cataract surgery in patients with POAG.

The analysis included 51 eyes that underwent the combined procedure, with outcomes assessed at 12, 24, and 36 months. Results showed a significant reduction in intraocular pressure (IOP) and medication use. At 12 months, IOP decreased from a baseline of 19.1 mmHg to 13.9 mmHg (P < 0.001), with medication use dropping from 2.3 to 1.2 (P < 0.001). These reductions remained stable at 24 months. At 36 months, IOP reduction was maintained, though medication use showed less consistent improvement.

In a subgroup with uncontrolled glaucoma (n = 27), IOP decreased from 21.9 mmHg to 14.6 mmHg (P = 0.006) at 36 months. Similarly, patients with severe disease (n = 12) experienced a significant IOP reduction at 12 months, though medication use remained unchanged. No eyes required additional glaucoma surgery during the study period.

Reference

Porter MS, Flowers A, Wood BP, et al. Efficacy and Safety of Cataract Surgery Combined with Ab Interno Canaloplasty and Micro-Trabecular Bypass Stent Surgery in Open-Angle Glaucoma. Clin Ophthalmol. 2025;19:469-481. doi: 10.2147/OPTH.S504247. PMID: 39959880; PMCID: PMC11829638.