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Published on: October 13, 2017
Comparative Efficacy of Standalone Ab-Interno Canaloplasty Versus Ab-Interno Canaloplasty Combined With
Hon Jen Wong1, Jiankai Sheng1, Devy Anggreni1
1Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Background:
Ab-interno canaloplasty (ABiC) may be performed as a standalone procedure or in combination with phacoemulsification (ABiC+Phaco). This study aims to examine the comparative surgical outcomes of both procedures.
Methods:
PubMed, EMBASE and CENTRAL were searched for randomised controlled trials, cohort studies and retrospective case series published from inception to 31 March 2025 that compared outcomes of standalone ABiC and ABiC+Phaco in the treatment of open-angle glaucoma (OAG). Random-effects meta-analysis was performed to pool the mean difference in intraocular pressure (IOP) and glaucoma medications compared to baseline.
Results:
Eight studies with a pooled total of 663 eyes were included in final analysis. There was no significant difference in IOP-lowering efficacy between ABiC+Phaco and standalone ABiC across all timepoints (6 months, 1 year, 2 years and 3 years) with a mean difference of 0.25 mmHg (95% CI: -0.98 to 1.48) at 3 years. There was also no significant difference in glaucoma medication reduction between ABiC+Phaco and standalone ABiC across all timepoints, with a mean difference of 0.03 medication reduction (95% CI: -0.18 to 0.23) at 3 years. A small IOP-lowering benefit of ABiC+Phaco versus standalone ABiC in primary OAG-only studies (mean difference 0.75 mmHg, 95% CI: 0.03-1.47) was observed at 3 years.
Conclusion:
Our meta-analysis suggests that phacoemulsification may not offer significant additional IOP and glaucoma medication reduction to standalone ABiC. However, results should be interpreted with caution due to a moderate risk of bias across all included studies. Regardless, our findings are consistent with existing literature on the effect of adjunctive phacoemulsification on other ab-interno MIGS.
