360° ab-interno Schlemm's canal viscodilation in primary open-angle glaucoma

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Minimally Invasive Glaucoma Surgery (MIGS)

Background:

• Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness worldwide.
• Current treatments aim to lower intraocular pressure (IOP) but often require medication or invasive surgery.
• Schlemm's canal (SC) is a key structure in the eye's aqueous humor outflow pathway.

Purpose of the Study:

• To evaluate the safety and effectiveness of ab-interno microcatheterization and 360° viscodilation of Schlemm's canal (SC) using the VISCO360® Viscosurgical System.
• To assess the impact of this procedure on intraocular pressure (IOP) and the need for IOP-lowering medications in POAG patients.
• To determine the rate of adverse events and secondary surgical interventions associated with the VISCO360 procedure.

Main Methods:

• Retrospective analysis of 106 eyes from 71 consecutive patients with mild-moderate POAG.
• Ab-interno SC viscodilation (VISCO360®) performed with or without cataract extraction.
• Patients divided into two groups based on baseline IOP: Group 1 (≥18 mmHg) and Group 2 (<18 mmHg).
• IOP and medication use documented at baseline and follow-up visits (12±3 months).

Main Results:

• Group 1 (n=72) showed a 41.0% mean IOP reduction (24.6 to 14.6 mmHg) at 12 months, with 87% achieving ≥20% IOP reduction.
• Group 2 (n=34) maintained baseline IOP throughout the follow-up period.
• Both groups experienced a significant decrease (>89%) in medication use, with 86% of eyes becoming medication-free.
• Most common adverse event was hyphema (13%); no secondary surgical interventions were required.

Conclusions:

• Ab-interno SC viscodilation with VISCO360® is a safe and effective MIGS procedure for POAG.
• The treatment leads to significant IOP reduction and decreased reliance on hypotensive medications.
• VISCO360® offers a promising therapeutic option for managing POAG with a favorable safety profile.