ABiC Glaucoma Procedure
Publish date 24-02-2018

ABiC Glaucoma Procedure. itrack diaghram





ABiC Glaucoma Procedure

Ab Interno Canaloplasty or ABiC is a new minimally-invasive Glaucoma Surgery (MIGS) procedure that is based on the same principles of angioplasty.

ABiC uses a microcatheter technology to dilate the drainage channels in the eye in order to improve aqueous outflow without a stent or shunt. It’s a comprehensive procedure that covers the trabecular meshwork, Schlemm’s canal and the collector channels to be able to treat all possible sources of outflow resistance.

ABiC uses iTrack , an illuminated micron-scale microcatheter, to viscodilate the Schlemm’s canal during the procedure.Instead of changing or bypassing the natural aqueous outflow pathways, ABiC is designed to restore the natural outflow pathway by addressing all drainage channels.

ABiC is an FDA-approved procedure performed to control the eye or intraocular pressure (IOP) without damaging tissues and without the placement of permanent implants in the eye.

Indications of ABiC

ABiC is indicated for the reduction of elevated IOP in patients with open-angle glaucoma (OAG), including those with ocular surface disease (e.g. dry eye syndrome, blepharitis, meibomian gland dysfunction, scarring from glaucoma medications, etc.), and patients intolerant of anti-glaucoma medications.

Other indications of ABiC:


  1. Pigmentary Glaucoma (PG)

  2. Pseudoexfoliation Glaucoma (PXF)

  3. Ocular Hypertension

  4. Patients after treatment with Selective Laser Trabeculoplasty (SLT)

  5. Patients post single session low-power Argon Laser Trabeculoplasty (ALT)

  6. Patients with previous failed trabeculectomy or tube surgery

  7. OAG with narrow but not occludable angles after laser iridectomy

  8. Normal Tension Glaucoma (NTG)

  9. Juvenile Glaucoma

  10. Steroid-induced Glaucoma




Contraindication of ABiC Glaucoma Procedure


  1. Neovascular Glaucoma

  2. Multiple Argon Laser Trabeculoplasty (ALT)

  3. Chronic Uveitis

  4. Chronic Angle Closure Glaucoma

  5. Traumatic/Angle Recession Glaucoma

  6. Narrow inlet with plateau iris

  7. OAG with narrow angle (unless canaloplasty and phacoemulsification will be done at the same time)

Most common side effects associated with ABiC


  1. Intraocular pressure spikes

  2. Hypotony (low intraocular pressure: 5mmHg or less)

  3. Bleeding in the eye

  4. Formation of a bleb




ABiC Glaucoma Procedure steps


  1. The eyes will be anesthetized during the procedure.

  2. A small incision will be made in the eye at the junction between the cornea and the sclera

  3. A microcatheter will be inserted into the drainage canal.

  4. The microcatheter will be advanced around the canal to open the channel and enlarge it.

  5. The microcatheter tip is then withdrawn slowly while sterile, viscoelastic gel is injected into the canal to enlarge it to about 2-3 times its normal size.

  6. The microcatheter is then withdrawn completely out of the eye.


The Iintraocular pressure usually drops one to three days after the procedure. It's minimally invasive allowing quicker recovery. The patient can resume normal activities right after the treatment.

ABiC has been proven to be clinically effective in reducing the intraocular pressure with high safety profile. Compared to other traditional glaucoma surgeries, ABiC has significantly lower risks. ABiC can be used in conjunction with anti-glaucoma medications and can be performed after laser or other types of surgery.

ABiC can also be performed with or without cataract surgery. In case the procedure is unsuccessful, other glaucoma treatment options can be used as ABiC does not affect future treatment results.

Regular visits with an eye doctor should be continued as glaucoma treatment is a life-long process.