Monisha Vora, MD, a glaucoma and cataract surgeon at Kremer Eye Center in Philadelphia, decided to try the Omni Surgical System Ergo-Series (Omni Ergo) from Sight Sciences because she wasn’t getting the intraocular pressure (IOP) reduction and durability she needed for her patients with other procedures. “I was excited to try the technology when it debuted because of its mechanism of action and comprehensive approach to treating glaucoma,” she says.

Matthew Brink, MD, a glaucoma and advanced anterior segment surgeon at Center for Excellence in Eye Care in Miami, says the Omni Ergo allowed him to use an ab interno, implant-free approach with his patients to achieve excellent IOP control with minimal risks and complications. “Adopting this technology was an obvious choice because Sight Sciences has always prioritized a surgical approach intended to address the root cause of disease. The company has an excellent track record of strong clinical data and innovative technology development,” he says.

Omni Ergo.
Image courtesy of Sight Sciences.

Capabilities

According to Reay Brown, MD, a glaucoma specialist and chief medical officer of Sight Sciences, the Omni Ergo enables surgeons to provide implant-free, minimally invasive glaucoma surgery (MIGS) to reduce IOP in adults with primary open-angle glaucoma. By using Omni technology, a surgeon can address all 3 known points of resistance in the aqueous outflow system: Schlemm’s canal, collector channels, and the trabecular meshwork. It can be used before, in combination with, or following cataract surgery.

“The innovations in the technology enable surgeons to perform an efficacious and durable procedure for every patient at any stage of their disease,” Dr. Brown says.

Adds Dr. Brink, “The technology features a cannula tip that enables gentle and precise access to Schlemm’s canal while continuing to facilitate a full 360° microcatheterization. As its name implies, the focus is on the surgeon’s experience and how it feels in the hand. With Omni Ergo, I can access Schlemm’s canal with improved precision.”

Features and Benefits

Among the product’s features are improved handle ergonomics, hence the name “Ergo.” The handle is designed to enable surgeons to more easily rotate and position the cannula tip within Schlemm’s canal with precise finger rotations vs wrist adjustments, Dr. Brown says.

According to Dr. Vora, “The surgeon-controlled wheel enables surgeons to directly control the microcatheter for what the company describes as motion-synchronized constant volume hydrodilation of viscoelastic from an internal reservoir. The wheel has enhanced prominence and wider ridges to improve tactile feedback. I have small hands, and don’t have any problems using it.”

Furthermore, viscoelastic preparation within the internal reservoir has been simplified. The handle’s viscoelastic luer connector is removable and detaches when the viscoelastic cartridge is removed, resulting in additional clearance with the surgical microscope, Dr. Brown says.

Adds Dr. Brink, “The cannula tips provide pinpoint accuracy for incising and entering Schlemm’s canal. The microcatheter feels robust and allows me to dissect herniated trabecular tissue and smoothly open the strictures within Schlemm’s canal.”

Clinical Applications

The Omni Surgical System is the first glaucoma device technology indicated for canaloplasty followed by trabeculotomy that allows surgeons to perform implant-free glaucoma surgeries as well as a combination cataract-glaucoma procedure, regardless of the stage of a patient’s primary open-angle glaucoma. Omni Ergo enables surgeons to access 360° of the diseased conventional outflow pathway, and it can be used in adult patients with primary open-angle glaucoma across the spectrum of disease severity, Dr. Brown says. Dr. Vora uses Omni technology when operating on a broad spectrum of patients with mild-to-moderate glaucoma who use 1 to 2 medications per day to lower IOP.

“I like that Omni is the only minimally invasive, implant-free technology indicated for standalone procedures regardless of disease severity, which opens an opportunity to expand my use and patient population,” Dr. Vora says.

Advantages

The technology has many benefits for both patients and clinicians. Patients benefit because the procedure often decreases their medications or drop burden, Dr. Vora says. It may also delay or eliminate the need to perform more invasive surgical procedures.

Dr. Brink has found that the procedure does an excellent job of lowering IOP. He prefers the Omni Ergo for outflow restoration in almost every circumstance.

Furthermore, Dr. Vora says that the improvements in the priming of the device are intuitive for her as well as for staff members to prepare for procedures. “A procedure enabled with Omni Ergo technology gives surgeons the predictability and confidence that they will have good outcomes for their combination or standalone cases without performing aggressive and invasive procedures,” Dr. Vora concludes. GP