Streamline Surgical System Showcased at AGS Meeting

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The management of open-angle glaucoma (OAG) and visually significant cataracts presents ongoing challenges, particularly in addressing healthcare disparities and optimizing treatment outcomes within specific demographic groups. Two recent studies, presented at the 2024 American Glaucoma Society Annual Meeting, shed light on surgical approaches using the Streamline Surgical System. The first study1 explores the effectiveness of canaloplasty with the Streamline Surgical System combined with phacoemulsification in treating OAG and cataracts among Hispanic adults, showcasing significant reductions in intraocular pressure (IOP) and medication use at the 12-month follow-up. Meanwhile, the second study2 focuses on the combination of goniotomy and canaloplasty with the Streamline Surgical System with cataract extraction, demonstrating long-term success in reducing IOP and medication dependency, with notable improvements in visual acuity. Both studies underscore the potential of these surgical interventions to address the complex needs of patients with OAG and cataracts, emphasizing the importance of tailored approaches to optimize outcomes across diverse populations.

In the first study, Lazcano et al investigate the efficacy of canaloplasty with the Streamline Surgical System combined with phacoemulsification in Hispanic adults with OAG and cataracts, presenting evidence of its effectiveness in reducing IOP and medication dependency over 12 months.

The study enrolled 45 Hispanic adults diagnosed with OAG across 3 clinical sites. All participants had been previously treated with topical medical therapy for their condition. The primary outcome measured was the proportion of eyes achieving an IOP reduction of ≥20% from baseline, without medication, at the 12-month mark.

Results from the study revealed promising findings. Among the 42 participants who completed the 12-month follow-up, 69% remained medication-free, with 96.6% achieving the desired IOP reduction. Additionally, the mean IOP at month 12 significantly decreased by 34.2% from baseline, reaching 15.2 mmHg. There was a substantial reduction in medication use, with a mean decrease of 75% compared to the pre-washout baseline.

The most common adverse events were transient IOP elevation (n = 3), corneal striae (n = 3), hyphema (n = 2), and dry eye (n = 2).

These findings not only contribute to the understanding of glaucoma treatment but also highlight the importance of tailoring interventions to specific demographic groups to optimize outcomes and address healthcare disparities.

In the second study, Gebreyesus et al investigate the long-term outcomes of goniotomy and canaloplasty with the Streamline Surgical System, combined with cataract extraction, in patients with OAG.

Conducted at a single site, the study included 38 eyes from 26 patients diagnosed with mild to severe OAG. Most participants had primary OAG, comprising 82% of the cohort, with 68% classified as having mild disease.

Surgical success, defined as an IOP reduction of ≥20% and/or a reduction of ≥1 topical glaucoma medication, was achieved in 66.7% of all eyes at the 1-year mark. Success rates were notably higher in eyes with mild disease compared to severe disease, reaching 72.7% and 50%, respectively. Additionally, mean IOP at 1 year was significantly reduced to 14.3 mmHg, with a mean pre-operative IOP of 16.1 mmHg. Medication use was also notably reduced, with 53.3% of all patients being medication-free at 1 year.

Furthermore, best-corrected visual acuity showed significant improvement at the 1-year mark compared to baseline, indicating positive outcomes beyond just IOP reduction.

1. Lazcano G, et al.12 Month Outcomes of Canaloplasty Combined with Phaco in Hispanic Adults with OAG in a Multicenter Study. Poster presented at: 2024 American Glaucoma Society Annual Meeting. February 29, 2024.

2. Gebreyesus HW, et al. One Year Clinical Outcomes with the STREAMLINE Surgical System in Mild to Severe Open Angle Glaucoma. Poster presented at: 2024 American Glaucoma Society Annual Meeting. February 29, 2024.