New Minimally Invasive Option Now Available for Glaucoma Patients
Sight Sciences unveils next-generation surgical system to address fluid drainage in eye pressure management. Learn about OMNI Ultra and how it works.
Glaucoma surgical system
A New Approach to Managing Glaucoma Surgery
If you’ve been diagnosed with primary open-angle glaucoma and your eye pressure remains difficult to control with medication alone, you may have heard about minimally invasive glaucoma surgery (MIGS) as an alternative to traditional procedures. Sight Sciences, a medical device company based in Menlo Park, California, recently announced the commercial availability of its OMNI Ultra Surgical System, adding another option to the growing landscape of implant-free glaucoma interventions.
The OMNI Ultra represents the latest advancement in the company’s OMNI product family, which first received FDA approval in 2021. This handheld, single-use device is designed to reduce intraocular pressure by targeting specific areas within the eye’s natural drainage system—specifically the trabecular meshwork, Schlemm’s canal, and the collector channels.
Understanding How the OMNI Ultra Works
To understand why this device matters, it helps to know how glaucoma develops. In open-angle glaucoma, the eye’s drainage system—where fluid naturally flows out of the eye—becomes less efficient over time. This causes fluid to accumulate, raising the pressure inside the eye. That increased pressure can damage the optic nerve, potentially leading to vision loss if left untreated.
The OMNI Ultra uses a two-step procedure called canaloplasty followed by trabeculotomy. During canaloplasty, the device gently stretches and opens Schlemm’s canal using a technology called TruSync Plus, which creates temporary viscodilation—essentially widening the drainage pathway. The system can access the entire circumference of Schlemm’s canal with a single pass, which is a notable feature of this design.
The trabeculotomy step involves creating small openings in the trabecular meshwork, the tissue that lines the drainage angle. By doing this, fluid has a more direct pathway to exit the eye. Unlike some glaucoma surgeries that require implants or tubes, the OMNI Ultra works entirely within the eye’s existing drainage architecture.
Who Is a Candidate for OMNI Ultra Treatment?
The OMNI Ultra is specifically indicated for adult patients with primary open-angle glaucoma who need to reduce their intraocular pressure. This makes it relevant for people who have not achieved adequate pressure control with eye drops, or those who experience side effects from topical medications that make daily use difficult.
One advantage is its versatility. The procedure can be performed as a standalone operation or combined with cataract surgery. For older adults who develop both conditions, having the option to address both during one surgical session may reduce overall recovery time and risks associated with multiple procedures.
Enhanced catheter visualization is another feature built into the OMNI Ultra. This allows the surgeon to see the instruments more clearly during the procedure, potentially improving precision and reducing operating time.
The Evolution of Minimally Invasive Glaucoma Surgery
Minimally invasive glaucoma surgery has transformed how eye surgeons approach pressure management over the past decade. Traditional glaucoma surgeries like trabeculectomy or tube shunt implants are effective but more invasive, requiring larger incisions and sometimes creating permanent openings in the eye wall. MIGS procedures like the OMNI Ultra aim to achieve meaningful pressure reduction with less tissue trauma and faster visual recovery.
The OMNI technology platform itself was not new when Sight Sciences announced the OMNI Ultra. The company received its first FDA glaucoma clearance for its OMNI platform in 2021, which means the underlying technology has been used and studied in clinical practice for several years. The OMNI Ultra is described as the latest generation of that product family, suggesting refinements based on surgeon and patient feedback.
Sight Sciences also manufactures technology for dry eye disease management, including its TearCare System. At the same time the company announced the OMNI Ultra, it previewed an updated accessory called the Clearance Assistant Plus, designed for meibomian gland expression and eyelid debridement in dry eye treatment.
What to Expect if You Undergo OMNI Ultra Procedure
Minimally invasive procedures like OMNI Ultra generally involve smaller incisions than traditional glaucoma surgery, which typically means faster healing and quicker return to normal activities. However, the specific timeline and post-operative care instructions should come directly from your ophthalmologist, as individual healing varies.
The goal of any glaucoma procedure is sustained pressure reduction. Ideally, the pressure-lowering effect should persist long-term, though some patients may eventually need additional treatment as the eye continues to age and the disease progresses.
The OMNI Ultra uses implant-free technology, which means there are no permanent devices left inside the eye. This is distinct from some other MIGS approaches that place tiny stents or tubes to improve drainage. For some patients and surgeons, an implant-free approach carries psychological or practical advantages—there’s no foreign object in the eye, and no specific restrictions on imaging procedures like MRI in the future.
When to Consider Glaucoma Surgery
Not every glaucoma patient needs surgery. First-line treatment is almost always eye drops, which work for many people when used consistently. However, surgery may be considered if eye drops alone do not adequately control pressure, if a patient cannot tolerate the side effects or cost of multiple medications, or if the disease is progressing despite medical therapy.
If you have been diagnosed with glaucoma or are at high risk (family history, elevated eye pressure, African descent, or age over 60), regular eye exams with intraocular pressure measurement are essential. During an eye exam, your ophthalmologist may use tonometry to measure pressure and gonioscopy to visualize the drainage angle directly.
When to See Your Doctor About Glaucoma
Schedule an appointment with an eye care professional if you experience sudden eye pain, redness, or blurred vision, as these can indicate acute glaucoma. If you have a family history of glaucoma, are over 40, or have other risk factors, ask your primary care doctor for a referral to an ophthalmologist for baseline eye pressure screening.
If you have already been diagnosed with glaucoma and are struggling to control your eye pressure with drops, or if you experience side effects from medications, discuss your concerns at your next visit. Your ophthalmologist can review all available treatment options, including minimally invasive surgeries like the OMNI Ultra if they determine you’re a suitable candidate.
Looking Ahead
The OMNI Ultra was highlighted at the American Academy of Ophthalmology’s annual meeting, held October 9-12 in New Orleans, Louisiana, where the company showcased the system to eye care professionals. As more surgeons become trained in this technique and more patient data accumulates, the clinical community will continue to refine our understanding of its long-term outcomes and optimal use cases.
Glaucoma management continues to evolve, offering patients more choices than ever before. If you’re living with this condition or suspect you may be at risk, staying informed about both medical and surgical options—and maintaining regular eye care—remains your best defense against vision loss.
