Abstract:AIM: To evaluate the one-year clinical outcomes of a novel canaloplasty device used in combination with cataract extraction (CE) in patients with mild to severe open angle glaucoma (OAG). METHODS: This study reviewed patients diagnosed with mild to severe OAG, who underwent canaloplasty with the STREAMLINE® Surgical System combined with CE. The primary outcome was surgical success, defined as achieving ≥20% intraocular pressure (IOP) reduction and/or a reduction of ≥1 glaucoma medication compared to baseline. Secondary outcomes included mean IOP, average number of glaucoma medications, and best-corrected distance visual acuity (BCDVA). Data was collected preoperatively and at multiple postoperative time points up to one year. RESULTS: A total of 68 eyes of 47 patients were included with mean age was 73.1±7.0y and 60% were females. Surgical success at one year was achieved in 68.8% of eyes, with 67.6% success in mild, 80.0% in moderate, and 66.7% in severe OAG cases. IOP was significantly reduced from a baseline of 16.1±0.5 to 14.7±0.4 mm Hg at one year (P=0.0004). The number of medications decreased significantly in all eyes from a baseline of 1.2±0.1 to 0.6±0.1 at one year (P<0.0001). When stratified by glaucoma severity, only the mild group experienced a statistically significant decrease from a baseline of 1.1±0.1 to 0.4±0.1 (P<0.0001). BCDVA improved significantly from baseline to one year. No sight-threatening complications were reported. CONCLUSION: Canaloplasty using the STREAMLINE® surgical system combined with CE effectively reduces IOP at one year in mild to severe OAG with minimal complications. IOP lowering efficacy, reduction in IOP lowering medications, and safety in moderate to severe OAG require further study.