Purpose:

To determine the effect on intraocular pressure (IOP) and medication use of an ab interno trabeculotomy combined with viscodilation of Schlemm’s canal using the OMNI® Surgical System (Sight Sciences, Inc.) that was released in 2018 with or without cataract extraction (CE) in patients with mild to severe open angle glaucoma (OAG).

Methods:

A retrospective chart review was performed in patients receiving OMNI surgery between April and September 2018 at a single center. The OMNI device was used to perform 360 viscodilation of Schlemm’s canal followed by 360 trabeculotomy in eyes receiving OMNI-alone surgery. In eyes undergoing CE as well as OMNI surgery, CE was performed prior to viscodilation and trabeculotomy. Pre- and post-operative intraocular pressures and hypotensive medications were collected. Intra- and post-operative adverse events were recorded.

Results:

The OMNI procedure was performed in 15 eyes of 13 OAG patients (age 73.6±11.4 yrs). Patients have been followed for an average of 4.1 months and the endpoint analysis was done using IOP data collected at the last two follow-up visits. Of 15 eyes, 8 eyes (53%) received OMNI-alone surgery and 7 eyes (47%) received OMNI+CE. A significant reduction (35%) in mean IOP (from 21.3±3.9 to 13.7±3.9; p<0.0001) with="" a="" 25%="" reduction="" in="" use="" of="" medications="" (from="" 2.6±0.8="" to="" 2.0±1.0)="" was="" seen.="" in="" 12="" eyes="" (80%)=""> 20% reduction in IOP was seen. The use of oral medications was eliminated in 2 patients. Hyphema of approximately 5% was seen in only 2 of 15 eyes (13%) both of which received OMNI-alone surgery.

Conclusions:

The OMNI system permits surgeons to perform both an ab interno trabeculotomy and viscodilation of Schlemm’s canal either during CE or as a stand-alone procedure. These early results demonstrate that the OMNI procedure may be effective in reducing IOP and the use of medications in a wide spectrum of OAG patients with a favorable safety profile.