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    Interventional procedure overview of ab interno canaloplasty for open-angle glaucoma

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    Efficacy summary

    IOP reduction

    In a before-and-after study of 60 eyes in 53 people, there was a statistically significant decrease in IOP from 20.7 mmHg before surgery to 13.6 mmHg at 12 months and 13.5 mmHg at 24 months after surgery (both p<0.001 compared to baseline). There was no statistically significant difference in the mean change in IOP between people who had canaloplasty alone and people who had canaloplasty and phacoemulsification (Gallardo, 2021).

    In a before-and-after study of 180 eyes in 130 people, results were presented as stratified by baseline IOP. In people with baseline IOP of ≥18 mmHg (n=111 eyes at baseline), there was a statistically significant decrease in IOP from 22.0 mmHg before surgery to 15.7 mmHg at 6 months and 17.2 mmHg at 12 months after surgery (both p<0.0001 compared to baseline). In people with baseline IOP of <18 mmHg (n=69 eyes at baseline), there was little change in IOP from before to after surgery (statistical significance not reported) (Tracer, 2020).

    In a before-and-after study of 89 eyes in 64 people, there was a statistically significant decrease in IOP from 24.5 mmHg before surgery to 16.5 mmHg at 12 months (p<0.0005) and 15.8 mmHg at 18 months (p<0.0005). There was no statistically significant difference in the mean change in IOP between people who had canaloplasty alone and people who had canaloplasty and phacoemulsification (Hughes, 2020).

    In a before-and-after study of 106 eyes in 71 people, eyes were stratified by baseline IOP. In people with baseline IOP of ≥18 mmHg (n=72 eyes at baseline), there was a statistically significant decrease in mean IOP from 24.6 mmHg before surgery to 14.6 mmHg at 12 months after surgery (p<0.001). In people with baseline IOP of <18 mmHg (n=34 eyes at baseline), there was no statistically significant change in mean IOP from before surgery to 12 months after surgery (Ondrejka, 2019).

    In a before-and-after study of 80 eyes in 73 people, there was a statistically significant decrease in mean IOP from 22.5 mmHg before surgery to 15.0 mmHg at 12 months after surgery (p<0.001). There was no statistically significant difference in the mean change in IOP between people who had canaloplasty alone and people who had canaloplasty and phacoemulsification (Toneatto, 2022).

    In a before-and-after study 71 eyes (total people not reported), there was a statistically significant decrease in mean IOP from 23.6 mmHg before surgery to 14.2 mmHg at 12 months after surgery (p<0.001) (Gillman, 2021).

    Glaucoma medicine reduction

    In the before-and-after study of 60 eyes in 53 people, there was a statistically significant decrease in the number of glaucoma medicines used per person from a mean of 2.8 before surgery to 1.1 at 12 months and 1.7 at 24 months after surgery (both p<0.001 compared to baseline). There was no statistically significant difference in the reduction in glaucoma medicine use between people who had canaloplasty alone and people who had canaloplasty and phacoemulsification (Gallardo, 2021).

    In the before-and-after study of 180 eyes in 130 people, results were presented as stratified by baseline IOP. In people with baseline IOP of ≥18 mmHg (n=111 eyes at baseline), there was no change in glaucoma medicine use per person from a mean of 0.9 before surgery to 1.0 at 12 months after surgery (p=0.7). In people with baseline IOP of <18 mmHg (n=69 eyes at baseline), there was a statistically significant decrease in the mean glaucoma medicine use per person from 1.1 at baseline to 0.6 at 12 months follow up (p<0.05) (Tracer, 2020).

    In the before-and-after study of 89 eyes in 64 people, there was a statistically significant decrease in the number of glaucoma medicines used from a mean of 2.5 before surgery to 1.8 at 12 months (p<0.0005) and 1.7 at 18 months (p<0.05). There was no statistically significant difference in the reduction in glaucoma medicine use between people who had canaloplasty alone and people who had canaloplasty and phacoemulsification (Hughes, 2020).

    In the before-and-after study of 106 eyes in 71 people, eyes were stratified by baseline IOP. In people with baseline IOP of ≥18 mmHg (n=72 eyes at baseline), there was a statistically significant decrease in mean glaucoma medicine use from 2.1 before surgery to 0.2 at 12 months (p<0.001). In people with baseline IOP of <18 mmHg (n=34 eyes at baseline), there was a statistically significant decrease in mean glaucoma medicine use from 1.8 before surgery to 0.2 at 12 months after surgery (p<0.001) (Ondrejka, 2019).

    In the before-and-after study of 80 eyes in 73 people, there was a statistically significant decrease in mean glaucoma medicine use from 3.2 before surgery to 1.9 at 12 months after surgery (p<0.001). There was no statistically significant difference in the reduction in glaucoma medicine use between people who had canaloplasty alone and people who had canaloplasty and phacoemulsification (Toneatto, 2022).

    In the before-and-after study 71 eyes (total people not reported), there was a statistically significant decrease in mean glaucoma medicine use from 2.9 before surgery to 0.6 at 12 months after surgery (p<0.001) (Gillman, 2021).

    Surgical success

    In the before-and-after study of 80 eyes in 73 people, eyes that reached a target IOP on no medicines were considered 'complete successes' and eyes that reached a target IOP on no more medicines than baseline were considered 'qualified successes'. At a target IOP of 16 mmHg or less and a 25% or more reduction in IOP, 10.3% of eyes were complete successes and a further 43.6% of eyes were qualified successes at 12 months. At a target IOP of 18 mmHg or less and a 25% or more reduction in IOP, 11.5% of eyes were complete successes and a further 50.0% of eyes were qualified successes at 12 months (Toneatto, 2022).

    In the before-and-after study 71 eyes (total people not reported), eyes that had a 20% or more reduction in IOP with no medicine were considered 'complete successes'. 'Qualified successes' were those who had a 20% or more reduction in IOP with no more medicine use than baseline. Failures were those that did not meet the criteria for success, or those that required additional glaucoma surgery or had loss of light perception. Complete success was achieved in 46% of eyes, with a further 19% achieving qualified success. Failure was seen in 35% of eyes, all due to uncontrolled IOP, 36.8% (7 eyes) of which required further filtering surgery (Gillman, 2021).