Ab Interno Canaloplasty and Trabeculotomy Outcomes for Mild, Moderate, and Advanced Open-Angle Glaucoma: A ROMEO...

Area of Science:

• Ophthalmology
• Glaucoma Research
• Surgical Outcomes

Background:

• Glaucoma management aims to reduce intraocular pressure (IOP) and medication burden.
• Understanding treatment efficacy across different glaucoma severities is crucial for patient care.
• The ROMEO (Retrospective, Observational, Multicenter Evaluation of OMNI) study evaluated ab interno canaloplasty and trabeculotomy.

Purpose of the Study:

• To investigate the association between glaucoma severity and outcomes of intraocular pressure (IOP) and medication use.
• To assess the effectiveness of ab interno canaloplasty and trabeculotomy in patients with varying degrees of glaucoma severity.

Main Methods:

• Post-hoc analysis of 127 eyes from the retrospective, multicenter ROMEO study.
• Eyes were categorized into mild, moderate, and advanced glaucoma based on visual field mean deviation (MD).
• Intraocular pressure (IOP) and medication outcomes were analyzed at 12 months post-surgery; regression analysis assessed MD relationship with IOP.

Main Results:

• Similar percentage IOP reductions (16.9-18.6%) and mean 12-month IOP (14-16 mmHg) were observed across all glaucoma severity groups.
• Medication use was reduced in all groups, with significant reductions noted in mild and moderate severity groups.
• No significant relationship was found between 12-month IOP and mean deviation (MD); secondary interventions were more common in advanced glaucoma.

Conclusions:

• Ab interno canaloplasty and trabeculotomy demonstrate comparable efficacy in reducing IOP and medication burden across mild, moderate, and advanced glaucoma.
• Glaucoma severity does not appear to be a limiting factor for achieving meaningful IOP and medication reductions with these procedures.