Clinical outcomes of canaloplasty via an ab-interno surgical technique using the iTrack device: a narrative review

This narrative review seeks to investigate intraocular pressure (IOP), glaucoma medication dependence and safety profile of canaloplasty performed via an ab-interno surgical technique using the iTrack canaloplasty microcatheter (Nova Eye Medical).

A literature search was performed in March 2022 using MEDLINE and EMBASE to identify all papers which performed ab-interno canaloplasty using the iTrack, either combined with phacoemulsification or as a standalone procedure in primary open angle glaucoma. IOP was the primary efficacy outcome. Secondary outcomes were glaucoma medication use and safety profile.

The search demonstrated 170 results of which 9 studies were included which totaled 365 eyes. Both IOP and number of medications were reduced at 12-24 months. IOP decreased from 20.0 ± 2.5 mmHg preoperatively to 13.8 ± 0.6 and at 14.0 ± 0.9 at 12 and 24 months; the number of medications was reduced from 2.5 ± 0.5 preoperatively to 0.8 ± 0.4 and 0.9 ± 0.6 at 12 and 24 months postoperatively. Comparable results were observed in the iTrack-alone and iTrack + phaco groups: IOP was reduced from baseline 20.5 ± 1.9 and 19.6 ± 3.0 to 14.3 ± 1.1 and 13.9 ± 1.1 24 months postoperatively respectively.

This review suggests that ab-interno canaloplasty as a standalone procedure or combined with phacoemulsification using the iTrack leads to a reduction in IOP and glaucoma medication use up to 24 months postoperatively.