ABiC

ABiC

The optimum in minimally invasive, canal-based glaucoma surgery

With a mild touch and manifest efficacy, ABiC™ performed with the iTrack™ surgical system is a comprehensive minimally invasive glaucoma surgery that can effectively reduce IOP and eliminate or reduce the medication burden. Restorative and atraumatic, ABiC™ can be performed across the entire glaucoma disease process – and in conjunction with other treatments and MIGS options.

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No tissue damage, no stents or shunts 

Performed with the iTrack™ surgical system from Ellex, ABiC™ comprehensively addresses blockages in the collector channels and flushes the outflow channels without damaging tissue and without leaving behind a stent or shunt. 

  • Restores the natural outflow pathway —safely and efficaciously
  • Addresses all outflow pathway resistance points — atraumatically
  • Comprehensively addresses blockages in the collector channel ostia
  • Can be performed in conjunction with cataract surgery, and as a standalone procedure
  • Can be performed across the entire glaucoma disease process — before, and after, other MIGS
  • Delivers 30% reduction in mean IOP and a 50% reduction in medication dependence1

Access, catheterize and viscodilate

ABiC™ re-establishes the eye’s natural outflow system by accessing, catheterizing and viscodilating the trabecular meshwork, Schlemm’s canal, and the distal outflow system. 360º viscodilation of Schlemm’s canal can separate the compressed tissue planes of the trabecular meshwork, causing any herniated inner wall tissue to withdraw from the collector channels. This complements the mechanic opening achieved via the circumnavigation of the iTrack™ microcatheter through Schlemm’s canal.

Removing the guesswork from MIGS

The most defining aspect of ABiC™ is its comprehensive approach. To date, ABiC™ is the only minimally invasive glaucoma surgery that successfully and comprehensively addresses all aspects of potential outflow resistance. This contrasts with other MIGS procedures, where only a segment of Schlemm’s canal is addressed, or where the trabecular meshwork is targeted in isolation. When using a stent-based MIGS there is a risk that the area of blockage will be missed or sub optimally treated.

Reduce medication dependence safely and effectively

ABiC™ performed with the iTrack™ surgical system is both safe and effective. On average, it achieves a reduction in IOP of 30% and a 50% reduction in medication dependence.1

Standalone or complementary

Intuitive and efficient, ABiC™ can be performed as a standalone procedure, or in conjunction with cataract surgery.

ABiC™ can also be deployed synergistically with Selective Light Therapy (SLT) to control IOP by restoring the natural outflow pathways. SLT stimulates cellular regeneration to create a healthier, more porous trabecular meshwork structure, and achieves an average 30% reduction in IOP when used as a first-line therapy. Additionally, ABiC™ can be used in conjunction with other MIGS devices or treatments — and, as an atraumatic procedure, it does not preclude future treatment options.

1. 228-eye ABiC 12-Month Case Series Data, presented at ASCRS 2016. Data on file. Ellex Medical.

“I have been a practicing glaucoma specialist for over 10 years. The introduction of ABiC has completely changed my glaucoma treatment paradigm. Not only has ABiC proven itself to be highly effective in lowering IOP and reducing medication dependence, it also offers an excellent safety profile. There is no manipulation of the conjunctiva, and the post-op recovery resembles that of cataract surgery.”

ABiC resources

Article

Meet the Masters of the New Comprehensive MIGS

This article from the September 2017 issue of The Ophthalmologist discusses the role of the MIGS procedure ABiC, ab interno canaloplasty. ABiC has grown into a procedure that is fast, effective, safe and easily combined with other MIGS interventions. Contributing authors include Mahmoud Khaimi, MD (USA), Norbert Koerber, MD, PhD (Germany), Mark Gallardo, MD (USA), Sev Teymoorian, MD (USA) and Leon Au, MD (UK).

Case Study

MIGS: Restoration of Normal Outflow Aqueous Pathways

The March 2018 issue of CRST featured an editorial and an accompanying case study on Ellex iTrack/ABiC featuring Dr. David Lubeck: "ABiC is the most versatile MIGS procedure. A viable option for all stages of glaucoma, its use should also be considered when previous medical, laser, or surgical treatment has failed to adequately lower IOP. It is elegant and straightforward to perform for surgeons who are comfortable with angle-based procedures. ABiC will continue to grow in popularity as surgeons realize its value and MIGS dominates the discussion of glaucoma treatment paradigms .” David Lubeck , MD (USA)

Case Study

MIGS: A New Paradigm to Treat Glaucoma

The February 2018 issue of CRST featured an article and accompanying case study on the syergies of ABiC and SLT and the benefits of performing these two procedures in combination featuring Dr. Mahmoud Khaimi: "ABiC is a comprehensive microinvasive glaucoma surgery (MIGS) procedure that addresses all aspects of outflow resistance. SLT is a tissue-sparing initiative that preserves the ability to perform angle-based surgery in the future, if necessary. ABiC and SLT work hand in hand to reduce or eliminate the use of topical medications, and SLT can be used as a diagnostic tool." Mahmoud A. Khaimi, MD

Whitepaper

ABiC Whitepaper: The Minimally Invasive Glaucoma Surgery that Keeps its Promise

ABiC - The Minimally Invasive Glaucoma Surgery that Keeps its Promise This whitepaper presents the preliminary 12-month results for ABiC, based on a 228-eye case series by Mahmoud A. Khaimi, MD and Mark J. Gallardo, MD. The preliminary results for ABiC are very encouraging – at this point similar to previously published Canaloplasty studies, notably the landmark multi-center prospective trial carried out at 15 clinical sites in 2005.

Article

Roundtable Discussion, MIGS with ABiC

This paper summerises the panel discussion on microinvasive glaucoma surgery (MIGS) sponsored by Ellex iTrack during World Glaucoma Congress in Helsinki. Led by Ike K. Ahmed, MD, panel members shared their collective wisdom and experiences with MIGS and ab interno Canaloplasty (ABiC; Ellex). In addition to discussing how they envision the roles of these technologies in the glaucoma armamentarium going forward, the surgeons looked at how, as MIGS gains in popularity, an increasing number of physicians are exploring the adjunctive nature of these procedures with other MIGS options and with selective laser trabeculoplasty (SLT).

Article

ABiC In the Media, Glaucoma Today

In this article, featured in the Dec 2015 issue of Glaucoma Today, ABiC pioneer Mahmoud A. Khaimi, MD (Dean McGee Eye Institute) addresses his experience with the procedure to date, including his preliminary 6-month results. Dr. Khaimi also compares ABiC to other MIGS procedures. "ABiC offers a comprehensive approach to micro invasive glaucoma surgery (MIGS) by accessing, catheterizing, and viscodilating all aspects of outflow resistance—the trabecular meshwork, Schlemm canal, and the distal outflow system beginning with the collector channels. ABiC is an innovative way of using a proven technique and technology earlier in the disease process, and the procedure can be performed during cataract surgery as well as on pseudophakic patients.With a variety of different MIGS approaches now available to surgeons or forthcoming, it is worth noting that other techniques are less comprehensive than ABiC in that they address specific—but not all—aspects of the ocular outflow system."

Associated websites

Physician iTrack Blog

Ab interno canaloplasty (ABiC) truly is the next generation of MIGS (minimally invasive glaucoma surgery). With a mild touch and manifest efficacy, it is a swift procedure that preserves the conjunctiva, with great outcomes and a fast recovery and can be performed both during and independently of cataract surgery.

Associated websites

iTrack Patient Education

A simple three-step procedure, ABiC™ can reduce the elevated intraocular pressure associated with glaucoma. It can also free you from the financial and lifestyle burdens of glaucoma medications.

Video

ABiC: A Comprehensive Solution

In this video interview, Canaloplasty expert Mahmoud A. Khaimi, MD, describes the advent of ABiC, which is Canaloplasty performed via an ab interno approach to Schlemm’s canal.

Video

ASCRS Glaucoma Roundtable: ABiC in the Spotlight

Iqbal Ike K. Ahmed, MD, FRCSC, asks a group of experts featuring Mark J. Gallardo, MD; Nathan M. Radcliffe, MD; Mahmoud A. Khaimi, MD; David Richardson, MD; and I. Paul Singh, MD, to address the misconceptions and barriers to adoption for ab interno canaloplasty (ABiC).

Video

ASCRS Glaucoma Roundtable: MIGS in Daily Practice

Iqbal Ike K. Ahmed, MD, FRCSC, opens up discussion on preferred minimally invasive glaucoma surgery (MIGS) procedures. Mark J. Gallardo, MD; I. Paul Singh, MD; Mahmoud A. Khaimi, MD; David Richardson, MD; and Nathan M. Radcliffe, MD, each describe their approach to MIGS and discuss the mechanism of action of ABiC iTrack (Ellex).

Video

ABiC: iTrack Animation

Watch the iTrack as it circumnavigates Schlemm’s canal during ABiC (ab-interno Canaloplasty), separating the herniations of the meshwork into the collector channels and breaking inner lumen adhesions.

Video

ABiC: Restoring the Outflow Pathway

Restoring the Natural Outflow Pathway Mahmoud A. Khaimi, MD Dean McGee Eye Institute, USA

Video

ABiC According to the Expert

According to ABiC expert Mark J. Gallardo, MD, to become a successful ABiC surgeon, one must properly ensure good visualization of the nasal drainage angle.

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Ellex is the manufacturer of the iTrack Canaloplasty microcatheter for the reduction of intraocular pressure (IOP) in adult patients with open-angle glaucoma. It has been approved for the indication of fluid infusion and aspiration during surgery, and for catheterization and viscodilation of Schlemm’s canal during the ABiC (ab-interno Canaloplasty) procedure. Ellex does not accept any responsibility for use of the iTrack Canaloplasty microcatheter outside of these indications.

iTrack™ has a CE Mark (Conformité Européenne) and US Food and Drug Administration (FDA) 510(k) # K080067 for the treatment of open-angle glaucoma.

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