DOI: 10.1097/ijg.0000000000002739 ISSN: 1057-0829

Tonographic Outflow Facility and Intraocular Pressure After Standalone OMNI Surgery

Andrew J. Swampillai, Thomas Sherman, Ananth Ranjit, Bhavin Patel, Michael Madekurozwa, Darryl R. Overby, Kin Sheng Lim

Precis:

The OMNI surgical device produces a statistically significant reduction in intraocular pressure and a significant increase in tonographic outflow facility at 3 months, which is found to be non-significant at 12 months for both parameters.

Purpose:

OMNI is a minimally invasive glaucoma surgical device designed to address all three points of conventional outflow resistance (juxtacanalicular trabecular meshwork, inner wall of Schlemm’s canal and resistance distal to canal). This study assessed its effects on intraocular pressure (IOP) and tonographic outflow facility (TOF) changes after medication washout.

Methods:

Thirty eyes of 30 patients with uncontrolled open angle glaucoma or ocular hypertension were prospectively recruited. Each patient underwent a 4-week washout baseline IOP measurement and TOF recording via digital Schiøtz tonography. Patients received standalone 360 degrees canaloplasty and 160-180 degrees trabeculotomy. Measurements were repeated at 3 and 12 months post treatment (with further washout).

Results:

At 3 months, a mean IOP reduction by 3.26 mmHg from baseline (27.25±9.0 vs. 23.99±10.84 mmHg, P =0.03) was achieved, with a statistically significant increase in TOF (0.068±0.045 vs. 0.14±0.090 µL/min/mmHg, P =0.0002). At 12 months, a mean IOP reduction of 1.57 mmHg was achieved (27.25±9.0 vs. 25.68±12.04 mmHg, P =0.6) with no significant TOF change (0.068±0.045 vs. 0.10± 0.09 µL/min/mmHg, P =0.07). Thirty-two percent experienced a > 20% IOP reduction (n=9) with 25% experiencing an IOP < 18 mmHg (n=7) at 12 months.

Conclusions:

This is the first study assessing the standalone effect of the OMNI device on both IOP and TOF change pre and post treatment. While an IOP reduction and increase in TOF was noted at 3 months, this was not statistically significant at 12 months.

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