Ab Interno Canaloplasty Reduces Intraocular Pressure: Suggests Study
A recent clinical breakthrough reveals that ab interno canaloplasty provides a powerful 26% reduction in intraocular pressure and a 50% drop in medication dependence that lasts for an entire decade, offering a durable, implant-free solution for long-term glaucoma management, as published in the Journal of Current Glaucoma Practice in April 2026.
While ab interno canaloplasty is recognized for dilating Schlemm’s canal and distal collector channels to restore natural aqueous humor outflow, data regarding its effectiveness over a decade has been historically limited; consequently, Dr. Norbert Koerber and Simon Ondrejka from Augencentrum Köln-Porz in Germany conducted the research to build upon their previous 4- and 6-year findings and evaluate its long-term clinical utility.
Therefore, the retrospective case series investigated 27 eyes from 22 patients with primary open-angle glaucoma (POAG) or pseudoexfoliative (PEX) glaucoma who underwent treatment with the iTrack microcatheter (Nova Eye Medical, Fremont, CA, USA), primarily as a procedure combined with cataract surgery, while excluding secondary forms of glaucoma such as uveitic or traumatic cases to evaluate changes in mean IOP and medication use over a span of up to 120 months.
Key Clinical Findings of the Study Includes:
Significant Pressure Reduction: The research found an overall 26% reduction in mean intraocular pressure, which decreased from a baseline of 19.9 mm Hg to 14.7 mm Hg at the final follow-up.
Reduced Medication Burden: Patients saw their medication needs halved, with the average number of glaucoma medications dropping from 1.9 to 1.0 agents.
Proven Decade-Long Durability: For the cohort reaching the 10-year milestone, a significant 24% reduction in IOP was maintained, demonstrating the lasting impact of the procedure.
Excellent Safety Profile: The study reported no serious intraoperative or postoperative complications, such as hyphema or sight-threatening events, reinforcing the safety of this tissue-preserving technique.
Visual Field Stability: Mean deviation (MD) of the visual field remained remarkably stable over the 10-year observation period, indicating successful preservation of visual function.
The results suggest that ab interno canaloplasty with the iTrack microcatheter provides sustained and durable reductions in both intraocular pressure and medication dependence for up to ten years.
These findings indicate that canaloplasty is a viable, long-term, and tissue-preserving surgical option for the management of open-angle glaucoma.
While the study provides the longest follow-up data currently available in the scientific literature, the relatively small size of the 10-year cohort suggests that larger prospective studies are needed to further validate these longitudinal outcomes.
Reference
Koerber N, Ondrejka S. Safety and Effectiveness Outcomes of Ab Interno Canaloplasty in Open-angle Glaucoma: 10-year Results. J Curr Glaucoma Practice 2026;20(1):11–13
