ABiC (Ab Interno Canaloplasty)

Also known as Ab-Interno Canaloplasty, ABiC™ is a minimally invasive glaucoma surgery (MIGS) that can effectively reduce the elevated eye pressure associated with glaucoma. To date, ABiC™ is the only MIGS procedure that successfully addresses all aspects of potential outflow resistance. That is, ABiC™ treats the trabecular meshwork (1), Schlemm’s canal (2) and the Collector Channel system (3). By addressing all aspects of outflow resistance ABiC™ is able to deliver an average reduction in eye pressure of 30%.1 It can also reduce your glaucoma medications by 50%.1

Additionally, ABiC™ is the only MIGS procedure which acts to restore the natural outflow pathway. In contrast, all other MIGS procedures bypass or mechanically change the eye’s natural drainage channel in order to reduce the elevated IOP associated with glaucoma.

Key Benefits of ABiC

  • Restorative treatment of eye’s natural drainage system
  • Sustained reduction of pressure in the eye
  • Reduced dependence on expensive medications
  • Minimally invasive for quicker recovery and return to daily activities
  • Limited risk of complications versus traditional surgical alternatives
  • No need for a permanent implant  or device in your eye
  • No limitations on your favorite activities

How does ABiC work?

ABiC™ is based on the same principles as angioplasty. It uses breakthrough microcatheter technology to enlarge your eye’s natural drainage system, improving outflow and lowering eye pressure. It is important to note that ABiC acts to restore the natural outflow system, rather than bypass it. And ABiC does not leave any permanent implant or device in your eye.

What happens during the procedure?

First, your doctor will make a small incision in the eye. A microcatheter designed specifically for ABiC™ is then inserted into the eye’s circumferential drainage canal, which may be reduced in size or closed due to the high pressure in your eye. Your surgeon will advance the microcatheter 360 degrees around the canal to open up the channel and enlarge it. Once the end of the catheter has circumnavigated to its point of entry, the microcatheter tip is slowly pulled back while sterile, viscoelastic gel is injected into the canal to dilate it to 2-3 times its normal size. Enlarging and flushing through the drainage canal and adjacent outflow channels helps the aqueous fluid to drain properly. The microcatheter is then withdrawn from the eye. It is important to note that there are no permanent implants or devices left in the eye.

By restoring your eye’s natural drainage system, the pressure inside your eye is usually lowered.

One to three days after the procedure, your intraocular pressure should drop significantly. And of course, your physician will want to re-check the treated eye during periodic follow-up visits.

Does ABiC hurt?

No. During the surgery your eye will be anesthetized. Post-surgery your surgeon will prescribe eye drops to reduce inflammation and to prevent pain.

Who will benefit from ABiC?

It is necessary to first undergo an ophthalmic examination to determine your eligibility for ABiC™.
ABiC™ is an effective surgical option for the majority of glaucoma patients. If you fit into any of the following categories, you’re a good candidate for ABiC™:

  • If you have primary open-angle, pseudoexfoliation, or pigmentary glaucoma. (If you’re not sure, ask your ophthalmologist.)
  • If you are intolerant of glaucoma medications, or have difficulty taking them as prescribed.
  • If you are about to have cataract surgery and wish to use this opportunity to reduce the number of glaucoma medications you are currently taking.
  • If it is difficult for you to commit to regular follow-up treatments, due to finances, lack of transportation, or other limitations.
  • If you have a history of failed ALT (argon laser trabeculoplasty) treatments.
  • ABiC is also suitable for patients who wear contact lenses. Patients with contact lenses are unable to undergo the traditional forms of glaucoma surgery (trabeculectomy or shunt).

ABiC™ is not suitable for patients with neovascular or chronic angle-closure glaucoma.

What results can I expect with ABiC?

ABiC™ is clinically proven to reduce intraocular pressure (IOP)1. As an added benefit, many patients who undergo ABiC™ no longer require anti-glaucoma medications, or can reduce the number of medications required.

You can resume normal, day-to-day activities, such as watching TV, immediately following treatment. It is important to remember that managing glaucoma is a lifelong process: even after ABiC™ and other glaucoma treatments, you will need to continue to visit your ophthalmologist every three to six months.

What are the side effects of ABiC?

One of the key advantages of ABiC™ is its high safety profile. It is associated with significantly fewer risks, both in number and severity, than traditional glaucoma surgeries. It is important to note, however, that all surgeries have risks associated with them. The most common risks associated with ABiC™ are:

  • Bleeding in the Eye
  • Intraocular Pressure “Spikes”
  • The Formation of a Bleb
  • Hypotony (IOP too low)

What if ABiC doesn’t work for me?

A key benefit of ABiC™ is that is does not preclude any other form of glaucoma treatment. If the procedure is not successful, your surgeon may elect to perform laser-based treatment, such as SLT, Canaloplasty or conventional glaucoma surgery (trabeculectomy). Medication may also be an option.

Patient Resources


Visit the website www.glaucoma-iTrack.com for an easy-to-understand introduction to glaucoma and ABiC, ab interno Canaloplasty.