The Impact of Interventional Glaucoma with and without Cataract Surgery in Early Open-angle Glaucoma: 24-month Results with a New Canaloplasty Device
Year: 2025
Type: article
Abstract: prevent disease progression, while eliminating the limitations of medication use and avoiding or delaying invasive surgery.8 Cataract extraction offers a natural juncture to address glaucoma proactively, and leveraging the timing of cataract surgery to introduce minimally invasive glaucoma procedures aligns with the goals of IG therapy without necessitating additional surgical interventions.Canaloplasty via an ab-interno technique with the iTrack exemplifies the benefits of MIGS in IG therapy due to its effective yet minimally invasive action.Adhesions and trabecular meshwork (TM) herniations in Schlemm's canal (SC) are mechanically cleared by 360° circumnavigation of a flexible microcatheter, while pressurized viscodilation flushes open the canal and collector channels, and IntroductIonGlaucoma is a neurodegenerative disorder involving gradual retinal ganglion cell loss, which, if untreated, culminates in irreversible blindness.The traditional treatment strategy involves a 'medications first' approach, starting with topical ocular hypotensives and gradually escalating to invasive surgery based on disease progression. 1 While effective, this algorithm involves long-term treatment with daily eyedrops, often multiple, leading to complications including ocular surface toxicity, 2 ongoing costs, 3 impaired quality of life (QOL), 4 and poor treatment adherence, increasing the risk of vision loss.5,6 Due to these significant drawbacks, there have been growing calls to replace the traditional treatment approach with a paradigm of earlier procedural intervention via minimally invasive therapies, called "interventional glaucoma" (IG).In this new treatment paradigm, minimally invasive glaucoma surgery (MIGS) plays a vital role.MIGS was originally designed to bridge the gap between medications and filtration surgery due to their ability to achieve intraocular pressure (IOP) control with minimal tissue destruction and a high safety profile, 7 providing a safer alternative to invasive surgery, especially in mild-to-moderate glaucoma.Accordingly, IG therapy is based on the proven benefits of MIGS, making an argument for minimally invasive surgical intervention earlier in the disease course across all glaucoma stages, even before attempting maximal tolerated medical therapy.This would proactively
Authors: Simon Ondrejka, Norbert Koerber
Language: English
Subfield: Ophthalmology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4414847026