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Real-World Outcomes of OMNI Surgical System Canaloplasty and Trabeculotomy in Secondary Glaucoma: Corticosteroid-Induced and Uveitic Etiologies
Natalie Chen, MD
Presenter:
Natalie Chen MD; Sarah Zhou, MD; Lauren Chen, MD; Bethlehem Wole, MD; Andrew Smith, MD; Austin Fox, MD
Authors:
Affiliation:
1. Gavin Herbert Eye Institute, University of California Irvine, Irvine CA United States
Purpose
To evaluate the real-world efficacy and safety of 360° canaloplasty and 180° trabeculotomy using the OMNI Surgical System in adult patients with corticosteroid-induced or uveitic glaucoma. While MIGS is established for primary open-angle glaucoma (POAG), its role in secondary open angle glaucoma remains underexplored. This retrospective, observational cohort study aims to address this gap by reporting clinical outcomes, medication burden, and complication rates in this high-risk population.
Methods
Retrospective chart review of adults (≥18 years) undergoing OMNI canaloplasty and trabeculotomy (standalone or combined with phacoemulsification) at one academic center from Jan 2020–Dec 2025. Inclusion required a diagnosis of steroid-induced or uveitic glaucoma and baseline IOP ≥18mmhg. Patients with POAG, angle closure, or prior incisional glaucoma surgery were excluded. Primary endpoint: surgical success (≥20% IOP reduction from baseline, IOP was not >21mmHg on 2 consecutive visits and additional glaucoma surgery was not needed at 6 months. Secondary endpoints: IOP and number of IOP-lowering medications at 1, 3, 6 months post-op. Statistical analysis used Kaplan-Meier survival analysis and paired t-tests.
Results
Twenty-two eyes were included. Surgical success was achieved in 17/22 eyes (77.3%) at 6 months postoperatively. There was a 40.98% reduction (p <0.0001) in mean IOP from 30.5mmHg (preoperative) to 16.4mmHg (6 months postoperative), with reduced IOP at each postoperative visit (Figure 1). There was a 30.45% reduction (p <0.0001) in average number of IOP lowering medications used from 3.9 medications (preoperative) to 2.6 medications (6 months postoperative), with reduced medication use at each postoperative visit (Figure 2). Only one eye required further glaucoma surgery, and one patient with known history of uveitis developed prolonged uveitis post operatively. No eyes lost ≥2 lines of vision, and there were no other postoperative complications observed.
Conclusions
In this high-risk cohort, OMNI canaloplasty and trabeculotomy provided significant and sustained reductions in IOP and medication use, with an excellent safety profile. These findings support the use of OMNI in corticosteroid-induced and uveitic glaucoma and highlight the need for larger, prospective studies to confirm these results.