Canaloplasty and Trabeculotomy Using the OMNI Surgical System in Three Patients with Angle Closure: A Case Series.

Abstract

Aim and background: The OMNI surgical system allows for 360° canaloplasty and trabeculotomy for patients with glaucoma, either as a standalone procedure or in combination with cataract surgery. There is currently limited evidence on its use in forms of angle-closure glaucoma, though other microinvasive glaucoma surgeries have been used. We present three patients with angle closure who underwent the procedure.

Methods: Retrospective review of three patients who underwent canaloplasty and trabeculotomy with the OMNI surgical system with forms of angle closure. Data on demographics, intraocular pressure (IOP), glaucoma medication use, best corrected visual acuity (BCVA), visual fields (VFs), and complications were collected for a 6-month period.

Results: Three eyes of three patients underwent the procedure: one with primary angle closure glaucoma (PACG), one acute angle closure, and one primary angle closure (PAC). All had surgery combined with phacoemulsification and intraocular lens (IOL) implantation. The mean age was 56 years. Preoperative IOP was 25.33 ± 2.49 mm Hg, improving to 11.67 ± 2.87 mm Hg at 6 months. Mean glaucoma medication use was reduced by 3.00, from 3.67 ± 1.21 to 0.67 ± 0.94. Preoperative mean BCVA was 0.10 ± 0.08 and 0.20 ± 0.08 LogMAR at 6 months. Mean deviation (MD) on VFs was -9.67 preoperatively and -6.72 at 6 months. Two patients had mild, self-limiting hyphema postoperatively which resolved without further intervention; no other complications were reported.

Conclusion: We have found the OMNI surgical system to be a safe, effective tool in the management of angle-closure glaucomas in a small cohort of patients.

Clinical significance: The OMNI surgical system has the potential to add a less invasive surgical solution in the management of angle closure glaucoma, prior to the use of filtering surgery such as trabeculectomy or glaucoma drainage device. Larger trials assessing the use of microinvasive glaucoma surgery (MIGS) in these patients will be eagerly received.

How to cite this article: Richardson-May J, Ibrahim SA, Law K, et al. Canaloplasty and Trabeculotomy Using the OMNI Surgical System in Three Patients with Angle Closure: A Case Series. J Curr Glaucoma Pract 2024;18(3):117-120.