Long-term study highlights canaloplasty’s promise in primary open-angle glaucoma management

Three modifications of canaloplasty (C) – ab externo (ABeC), mini-canaloplasty (miniABeC), and ab interno (ABiC) – have shown significant potential in lowering intraocular pressure (IOP) for individuals diagnosed with primary open-angle glaucoma (POAG) at a mild to moderate stage when performed concurrently with cataract removal, according to a study.

In a recent 3-year prospective assessment, complete success, defined as achieving IOP of 15 mmHg or lower without medication, was observed in 100% of the miniABeC group and 75% of the ABiC group. Additionally, qualified success, denoting IOP of ≤15 mmHg with the aid of antiglaucoma eye drops, was noted in 94% of the ABiC and miniABeC groups, and 100% of the ABeC group.

Over the course of the 3-year follow-up, significant reductions in median IOP were observed across all groups. In the ABeC group, IOP decreased from 22 to 15 mmHg, in the miniABeC group from 22 to 15 mmHg, and in the ABiC group from 21 to 15 mmHg compared to the post-washout stage. Notably, over 56% of patients post ABiC, 68.8% post miniABeC, and 75% post ABeC achieved a ≥20% reduction in IOP without the need for medications.

The number of antiglaucoma medications required decreased across all groups. At the 3-year mark, only 1 patient following ABeC and 4 subjects post miniABeC necessitated treatment. A single patient required reoperation and further intensification of topical treatment after miniABeC.

Reference
Kicińska AK, Rękas M. Safety and Efficacy of Three Modifications of Canaloplasty to Treat Open-Angle Glaucoma: 3-Year Outcomes. J Clin Med. 2023;12(20):6475. doi: 10.3390/jcm12206475. PMID: 37892612.