Evidence on the safety of ab interno canaloplasty for open-angle glaucoma shows no major safety concerns. Evidence on the efficacy is limited in quality and quantity, particularly in the long term. Therefore, this procedure should only be used with special arrangements for clinical governance, consent, and audit or research. Find out what special arrangements mean on the NICE interventional procedures guidance page.
Clinicians wanting to do ab interno canaloplasty for open-angle glaucoma should:
Inform the clinical governance leads in their healthcare organisation.
Give people (and their families and carers, as appropriate) clear information to support shared decision making, including NICE's information for the public.
Ensure that people (and their families and carers, as appropriate) understand the procedure's safety and efficacy, and any uncertainties about these.
Audit and review clinical outcomes of everyone having the procedure. The main efficacy and safety outcomes identified in this guidance can be entered into NICE's interventional procedures outcomes audit tool (for use at local discretion).
Enter details about everyone having ab interno canaloplasty for open-angle glaucoma onto a suitable registry and review local clinical outcomes.
Discuss the outcomes of the procedure during their annual appraisal to reflect, learn and improve.
Healthcare organisations should:
Ensure systems are in place that support clinicians to collect and report data on outcomes and safety for everyone having this procedure.
Regularly review data on outcomes and safety for this procedure.
Patient selection and treatment should be done by glaucoma specialists with training and experience in the technique.
Report any problems with a medical device using the Medicines and Healthcare products Regulatory Agency's Yellow Card Scheme.
Further research should report:
details of patient selection, including concurrent procedures, severity of glaucoma and concomitant therapy
long-term efficacy and safety outcomes.