Canaloplasty | iTrack Advance™

Canaloplasty, designed around physiology

Canaloplasty is an angle-based MIGS procedure designed to restore flow through the conventional outflow pathway using 360° catheterization and pressurized viscodilation. It works with the eye’s natural drainage anatomy, addressing resistance across the trabecular meshwork, Schlemm’s canal and collector channels. With microcatheter-based canaloplasty such as iTrack Advance, surgeons can navigate the canal with visual guidance while preserving tissue rather than relying on approaches that require cutting through the trabecular meshwork.

1. Grieshaber, M. C., Pienaar, A., Olivier, J., & Stegmann, R. (2010). Clinical evaluation of the aqueous outflow system in primary open-angle glaucoma for canaloplasty. Investigative Ophthalmology & Visual Science, 51(3), 1498–1504.Manik Goel, Renata GPicciani, Richard KLee, and Sanjoy KBhattacharya. Aqueous Humor Dynamics: AReview. Open Ophthalmol J. 2010; 4: 52 – 59. 

2. Smit, B. A., & Johnstone, M. A. (2002). Effects of viscoelastic injection into Schlemm's canal in primate and human eyes: Potential relevance to viscocanalostomy. Ophthalmology, 109(4), 786–792.

Lower IOP—Often With Fewer Or No Drops

Published outcomes report a clinically and statistically meaningful reduction in IOP from 20.5 to 13.3 mmHg at 36 months (1). A reduction in medication burden by up to 50% through 6 years has also been observed (2).

Proven Safety

Designed to work with patient physiology and without the need for any hardware, canaloplasty is reported to have a robust safety profile. In a prospective, real-world study of 254 patients (344 eyes), intraoperative complications were rare, with only one case (0.3%) of Descemet's membrane detachment reported. Postoperatively, adverse events occurred in 2.3% of eyes (n = 8). (3)

Real-world Credibility

Published outcomes from the iTrack Global Data Registry (iTGDR)—run through the independent International Glaucoma Surgery Registry (IGSR)—confirm that canaloplasty delivers consistent results across 12 sites in five countries, reflecting real-world data from different clinics, workflows, and patient populations. It's not one clinic's protocol—it's reproducibility across centers, countries, and case mixes. (3)

Schlemm’s Canal

The trabecular meshwork and beyond

360° catheterization and viscodilation aim to expand the canal and address focal narrowing along its circumference.

Trabecular Meshwork

A key site of outflow resistance

Canaloplasty is designed to gently separate compressed trabecular structures to support aqueous passage.

Collector Channels

Three points of outflow resistance

Pressurized viscoelastic delivery is intended to promote broader distribution toward collector channel ostia, supporting flow beyond Schlemm’s canal.

1. Gallardo, M. J. (2022). 36-month effectiveness of ab-interno canaloplasty standalone versus combined with cataract surgery for the treatment of open-angle glaucoma. Ophthalmology Glaucoma, 5(5), 476–482. 

2. Koerber, N., & Ondrejka, S. (2024). 6-year efficacy and safety of iTrack ab-interno canaloplasty as a stand-alone procedure and combined with cataract surgery in primary open-angle and pseudoexfoliative glaucoma. Journal of Glaucoma, 33(3), 176–182. 

3. Kerr, N., Lubeck, D., Barton, K., Aref, A. A., Cheng, J., Spaulding, J., Shoham-Hazon, N., Thomsen, S., Patel, S., Harasymowycz, P., Singh, H., Mercieca, K., & Ahmed, I. I. K. (2026).
A prospective, real-world, multicenter study to support the role of ab-interno canaloplasty in glaucoma management. American Journal of Ophthalmology, 284, 235–246.

What does canaloplasty do differently to other MIGSdevices?

Rather than attempt to mechanically change or bypass the pathway of aqueous outflow, canaloplasty acts tore-establish the natural flow of aqueousthroughout 360° of theconventional outflow pathway. Akin to angioplasty of the eye, canaloplasty combines aprocess of catheterization and pressurized viscodilation to address all potential points of blockage in the trabecular meshwork, Schlemm’s canal and the collectorchannels.

Canaloplasty is the best example of early glaucoma intervention.

Larissa Camejo, MD (USA)
Cataract surgery, glaucoma management
Center for Medical and Surgical Eye Care, Palm Beach Gardens, Florida

Canaloplasty comprehensively treats outflow locations, which is why it is my first go-to glaucoma procedure. I don't have the diagnostic capability to know where the obstruction is located or what level of resistance exists, and so I like to start off with a MIGS that addresses everything.

Mahmoud A. Khaimi, MD
Glaucoma Specialist
Dean McGee Eye institute, University of Oklahoma

How is canaloplasty different from other MIGS?

Compare canaloplasty with other glaucoma approaches across implants, tissue interaction and outflow pathway coverage.

Other MIGS (stent or TM-cutting)

Implant-free (no permanent device left behind)

Tissue-preserving approach (no tissue removal required)

Targets all three resistance sites (trabecular meshwork, Schlemm's canal, and collector channels)*

Aqueous outflow rejuvenation without redirection

iTrack™ Advance overview

More on canaloplasty

A practical overview of canaloplasty, focusing on conventional outflow anatomy and what the procedure is designed to do.

A closer look at the outflow pathway, including the trabecular meshwork, Schlemm’s canal and collector channels.

Clinical evidence highlights and real-world outcomes reported in published canaloplasty studies.

Canaloplasty experts share a quick word on what canaloplasty means to them.

Drs. Ike Ahmed, Paul Singh and more talk about canaloplasty in the clinic.

What the experts say about canaloplasty with iTrack™ Advance

Nova Eye Medical, equips your surgeons with the best equipment for a non-destructive, long-term, patient care focused solution.

Canaloplasty is the best example of early glaucoma intervention.

Larissa Camejo

Senior Glaucoma Specialist

The Canaloplasty is my favorite because of it’s versatility, and this, in combination with other MIGS procedures or other glaucoma procedures and medications, is one of the many ways that tailoring can be achieved.

David Lubeck

The collector channels go 360 degrees around, and I think that's one of the huge advantages of iTrack™ Advance and canaloplasty—being able to treat 360º in one fluid treatment

Morgan Micheletti

MD, FACS

That’s why canaloplasty makes so much sense: We’re treating the problem tissue in the eye, and more to the point, because of the high degree of safety, we are doing so earlier in the disease continuum.

Robert Noecker

MD, MBA

With canaloplasty, the fact that you can preserve the natural anatomy of the canal and the trabecular meshwork while also positively impacting filtration through the canal and the trabecular meshwork, as well as the distal collector channels, is hugely beneficial.