To prospectively assess the clinical effect of ab-interno transluminal viscoelastic delivery and trabeculotomy performed with the OMNI Surgical System in pseudophakic eyes on intraocular pressure (IOP) and the use of IOP-lowering medications in patients with open angle glaucoma (OAG).
Sex: All, ages: 22 Years to any
Inclusion Criteria:
* Male or female subjects, 22 years or older at the time of surgery
* History of uncomplicated cataract surgery and posterior chamber IOL implantation without compromise to the lens capsule, zonular dehiscence/rupture or vitreous prolapse, 6 months or more prior to Baseline Visit.
* Diagnosed with mild to moderate open angle glaucoma (e.g. primary open angle glaucoma, pigmentary glaucoma, pseudoexfoliative glaucoma) as documented in subjects' medical record substantiated using funduscopic exam or OCT and at least one visual field test with the Humphrey automated perimeter using the SITA Standard 24-2 testing algorithm.
* Mean deviation score must be better than or equal to -12.0 dB
* The visual field test may be historical (within 6 months prior to Screening Visit). If needed, visual field testing may be repeated between the Screening Visit and the Surgery Visit.
* At the Screening visit, IOP of ≤ 36 mmHg while on 1-5 ocular hypotensive medications1 with a stable medication regimen for at least 2 months.
* At Baseline visit, unmedicated diurnal i) IOP ≥ 22.5 and ≤ 39mmHg and ii) IOP at least 3 mmHg higher than screening IOP and iii) IOP at 7:30AM ≥ 24
* Scheduled for ab-interno transluminal viscoelastic delivery and trabeculotomy using the OMNI Surgical System.
* Shaffer grade of ≥ III in all four quadrants
* Able and willing to comply with the protocol, including all follow-up visits.
* Understands and signs the informed consent
Exclusion Criteria:
* Any of the following prior treatments for glaucoma:
* Laser trabeculoplasty ≤3 months prior to Baseline visit
* iStent or iStent Inject implanted ≤6 months prior to Baseline visit
* Endocyclophotocoagulation (ECP) or Micropulse laser ≤ 6 months prior to Baseline visit
* Trabeculectomy or other bleb forming procedure including Xen, Express, glaucoma draining device/valve
* Prior canaloplasty, goniotomy, or trabeculotomy
* Hydrus microstent
* Suprachoroidal stent (e.g. Cypass, iStent Supra)
* Acute angle closure, traumatic, congenital, malignant, uveitic or neovascular glaucoma
* Concurrent IOP-lowering procedure other than use of the OMNI Surgical System at the time of surgery (e.g. ECP, CPC, etc.)
* In the Investigator's judgement, predisposed to significant risk because of washout of ocular hypotensive medications
* Concurrent ocular pathology or systemic medical condition which, in the Investigator's judgment, would either place the subject at increased risk of complications, contraindicate surgery, place the subject at risk of significant vision loss during the study period (e.g., wet AMD, corneal edema, Fuch's dystrophy, active intraocular infection or inflammation within 30 days prior to Screening Visit, etc.), or interfere with compliance to elements of the study protocol (e.g., returning to Investigator's office for follow-up visits).
* History of penetrating keratoplasty or another corneal transplant
* BCVA of logMAR 1.0 (20/200) or worse in the fellow eye not due to cataract
* Study of OMNI System in POAG
* BCVA of logMAR 0.4 (20/50) or worse in the study eye not due to posterior capsular opacification (uneventful Nd:YAG laser capsulotomy 6 months prior to baseline is permitted only if there is no vitreous present in or in front of the iris plane at the time of baseline).
* Participation (≤ 30 days prior to baseline) in an interventional trial which could have a potential effect on the study outcome, as determined by the study investigator
* Women of childbearing potential if they are currently pregnant or intend to become pregnant during the study period; are breast-feeding; or are not in agreement to use adequate birth control methods to prevent pregnancy throughout the study
Participant flow
| Milestone | Pseudophakic Eyes With Open Angle Glaucoma |
|---|
| Started | 78 |
| Completed | 0 |
| Not completed | 78 |
Outcome results
- Change in Intraocular Pressure (IOP) (Primary), Mean, mmHg: Pseudophakic Eyes With Open Angle Glaucoma -8.8 +/- 7.3
- Change in Number of Medications (Secondary), Mean, number of hypotensive medications: Pseudophakic Eyes With Open Angle Glaucoma -1.2 +/- 1.3
Adverse events
Time frame: 6 months
| Arm | Deaths | Serious adverse events | Other adverse events |
|---|
| Pseudophakic Eyes With Open Angle Glaucoma | 0/78 (0.0%) | 2/78 (2.6%) | 20/78 (25.6%) |
Serious adverse events by term
| Term | Organ system | Pseudophakic Eyes With Open Angle Glaucoma |
|---|
| Renal Failure (unrelated) | Renal and urinary disorders | 1/78 |
| Coronary Artery Disease (unrelated) | Cardiac disorders | 1/78 |
Other adverse events by term
| Term | Organ system | Pseudophakic Eyes With Open Angle Glaucoma |
|---|
| COVID-19 (unrelated) | Respiratory, thoracic and mediastinal disorders | 1/78 |
| Vitreous Hemorrhage (unrelated) | Eye disorders | 1/78 |
| Iris Prolapse (unrelated) | Eye disorders | 1/78 |
| Posterior Capsular Opacification (unrelated) | Eye disorders | 1/78 |
| Corneal edema after 1 week | Eye disorders | 1/78 |
| Layered hyphema greater than or equal to 1mm (unrelated) | Eye disorders | 3/78 |
| Clinically significant cystoid macular edema (unrelated) | Eye disorders | 1/78 |
| IOP increase of 10 mmHg above baseline IOP at 1 month or later | Eye disorders | 1/78 |
| Benign paroxysmal positional vertigo (unrelated) | Eye disorders | 1/78 |
| Blepharitis (unrelated) | Eye disorders | 1/78 |
| Eye pain | Eye disorders | 1/78 |
| Headache (unrelated) | Eye disorders | 1/78 |
| Headache above left eye (unrelated) | Eye disorders | 1/78 |
| Iris atrophy (unrelated) | Eye disorders | 1/78 |
| Iris prolapse (unrelated) | Eye disorders | 1/78 |
| Macular edema (unrelated) | Eye disorders | 1/78 |
| Small blood clots in trabecular meshwork (unrelated) | Eye disorders | 1/78 |
| Superficial punctate keratitis (unrelated) | Eye disorders | 1/78 |
Limitations and caveats: Meaningful conclusions cannot be drawn due to early termination of the study due to a business decision.