iTrack™

REDEFINING THE TREATMENT OF MILD-MODERATE GLAUCOMA WITH CANALOPLASTY

iTrack™ is an implant-free MIGS procedure that achieves excellent clinical outcomes while also preserving the viability of future treatment options. Based on the same principles as angioplasty, iTrack™ combines 360° catheterization and pressurized viscodilation to treat all points of blockage in the proximal and distal outflow system – reducing intraocular pressure (IOP) to the low-teens. A reduction in patient dependence on medications has also been observed following iTrack™. 

iTrack™ comprehensively treats outflow locations, which is why it is my first go-to MIGS 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.”

ABOUT iTRACK™

  • Stent- and implant-free procedure
  • 30% average IOP reduction7,10,11
  • 50% average medication reduction 7,10,11
  • Minimal endothelial cell loss (-3.2%)12
  • Comprehensive — addresses all outflow pathway resistance points, including the collector channel ostia1,2
  • Can be performed in conjunction with cataract surgery or as a standalone procedure7,10,11

I view the angle as the new conjunctiva, because I want to manipulate it today – but I also want to preserve tissue. We all know that there’s not a single glaucoma procedure that lasts forever. I want to be able to come back and treat the patient again.”

iTRACK™ IS DESIGNED TO TREAT ALL SITES OF BLOCKAGE IN THE CONVENTIONAL OUTFLOW SYSTEM

With iTrack™ you can target and treat the trabecular meshwork, Schlemm’s canal and the collector channels. Not only has this been shown to comprehensively reduce IOP, but it also removes the guesswork inherent in stent-based MIGS procedures.

Not only does iTrack™ break the herniations that we see in the canal, but it also viscodilates. So, it’s really pushing out the entire distal channel and also opening up the trabecular meshwork.”

TRABECULAR MESHWORK

50 – 75% of outflow resistance is localized within the trabecular meshwork.

iTrack™ stretches the trabecular plates within the trabecular meshwork and creates microperforations into the anterior chamber.

SCHLEMM’S CANAL

The canal of a POAG patient tends to be shorter, more narrowed, and often collapsed.2

iTrack™ mechanically breaks adhesions within Schlemm’s canal and dilates Schlemm’s canal by up to 2 – 3 times via a process of pressurized viscodilation. 

COLLECTOR CHANNELS

Frequent herniations of the trabecular meshwork obstruct up to 90% of collector channels in POAG eyes.8

iTrack™ reduces herniations in the collector channels via a process of pressurized viscodilation. 

iTRACK™ IS THE WORLD’S FIRST CANALOPLASTY MICROCATHETER

Despite measuring just 250 microns in diameter – the equivalent of several strands of hair – the iTrack™ comprises an infusion pathway for the delivery of OVD and a proprietary guide-wire that enables it to traverse the full 360° of the canal in a single intubation. It also features a fiber optic for illuminating the distal tip. Importantly, iTrack™ is the only canaloplasty microcatheter that enables you to customize the amount of OVD delivered on an individual patient basis. 

+100 MICROLITERS OF OVD

iTrack™ delivers +100 microliters of OVD* over 360° of the canal. As observed via blanching of the episcleral veins immediately following the procedure4, iTrack™ improves flow through the entire conventional outflow system, including the distal portion.

* Testing using a robotically controlled ViscoInjector™ with time-recording mass data to simulate the delivery of OVD over 360° of Schlemm’s canal. Data available upon request.


PRESSURIZED VISCODILATION

The iTrack™ canaloplasty microcatheter is the only device to deliver OVD into Schlemm’s canal via a patented, pressurized mechanism (Patent No. US7,967,772,B2). 


SURGEON-CONTROLLED DELIVERY

With the iTrack™ canaloplasty microcatheter you can adjust the amount of OVD delivered based on the patency of Schlemm’s canal. 


SINGLE-PASS 360° CATHETERIZATION

With a flexible design and internal guide-wire, iTrack™ is the only canaloplasty device that can catheterize 360° of the canal during a single intubation.


INTELLIGENT NAVIGATION

A malleable yet rigid internal guide-wire within the iTrack™ canaloplasty microcatheter may minimize the risk of creating an artificial pathway. It also enables you to push through herniations and to maneuver through tight areas of the canal.


PROPRIETARY ILLUMINATION

A proprietary illuminated fiber optic tip provides continuous location feedback and helps to safeguard against misdirection of the iTrack™ canaloplasty microcatheter into the suprachoroidal space or the collector channels.

In Vivo Aqueous Venography for Glaucoma

Modification to Ab Interno Canaloplasty (ABiC) and Gonioscopy Assisted Transluminal Trabeculotomy (GATT) that provides real time 360 degree in vivo aqueous v…

1. Stegmann R, Pienaar A, Miller D. Viscocanalostomy for open-angle glaucoma in black African patients. J Cataract Refract Surg. 1999;25(3):316 – 322.2. Grieshaber MC, Pienaar A, Olivier J, Stegmann R. Clinical evaluation of the aqueous outflow system in primary open-angle glaucoma for canaloplasty. Invest Ophthalmol Vis Sci. 2010;51(3):1498 – 1504.3. Gillman K, Mansouri K, Ambresin A, Bravetti G, Mermoud A. A Prospective Analysis of iStent Inject Microstent Implantation: Surgical Outcomes, Endothelial Cell Density, and Device Position at 12 Months. J Glaucoma. Volume 29, Number 8, August 2020.4. Shiba D, Hosoda S, Yaguchi S, Ozeki N, Yuki K, Tsubota K. Safety and Efficacy of Two Trabecular Micro-Bypass Stents as the Sole Procedure in Japanese Patients with Medically Uncontrolled Primary Open-Angle Glaucoma: A Pilot Case Series. J Ophthalmol. 2017; 2017: 9605461.5. Popovic M, Campos-Moller X, Saheb H, Ahmed IIK. Efficacy and Adverse Event Profile of the iStent and iStent Inject Trabecular Micro-bypass for Open-angle Glaucoma: A Meta-analysis. J Curr Glaucoma Pract 2018;12(2):67 – 84.
6. ElMallah MK, Seibold LK, Kahook MY et al. 12-Month Retrospective Comparison of Kahook Dual Blade Excisional Goniotomy with iStent Trabecular Bypass Device Implantation in Glaucomatous Eyes at the Time of Cataract Surgery. Adv Ther 36, 2515 – 2527 (2019).7. Gallardo MJ, Supnet RA, Ahmed IIK. Viscodilation of Schlemm’s canal for the reduction of IOP via an ab-interno approach. Clinical Ophthalmology. Vol 12. August 2018.8. Source: Cha ED, Xu J, Gong H. Variations in active areas of aqueous humor outflow through the trabecular outflow pathway. Presented at ARVO 2015.)9. Allingham RR, de Kater AW, Ethier CR. Schlemm’s canal and primary open angle glaucoma: correlation between Schlemm’s canal dimensions and ouflow facility. Exp Eye Research 1996;62:101 – 1

10. Gallardo, MJ. 24-Month Efficacy of Viscodilation of Schlemm’s Canal and the Distal Outflow System with iTrack Ab-Interno Canaloplasty for the Treatment of Primary Open-Angle Glaucoma. Clinical Ophthalmology 2021:15 1591 – 1599.

11. Kazerounian S, Zimbelmann M, Lörtscher M, et al. Canaloplasty ab interno (AbiC) — 2‑Year-Results of a Novel Minimally Invasive Glaucoma Surgery (MIGS) Technique. Klinische Monatsblatter fur Augenheilkunde. 2020 Nov. DOI: 10.1055/a‑1250 – 8431.

12. D.M. Lubeck, MD, and R.J. Noecker, MD, unpublished data, 2020; accepted for presentation at ASCRS 2021.

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