In short: OMNI canaloplasty (Sight Sciences) is a keyhole glaucoma operation that, through a single tiny incision, both flushes open the full 360 degrees of your eye’s drainage canal (Schlemm’s canal) and opens 180 degrees of the trabecular meshwork. It is the only MIGS that treats all three points of drainage resistance, lowering pressure and cutting drops in mild-to-moderate open-angle glaucoma — without touching the conjunctiva, so future surgery stays possible.
What is OMNI canaloplasty?
In open-angle glaucoma, fluid drains too slowly because the eye’s natural outflow pathway — the trabecular meshwork, Schlemm’s canal and the tiny collector channels beyond — becomes resistant, so pressure rises and the optic nerve is at risk.
OMNI uses one small instrument, passed through a 1.6 mm corneal incision under direct view of the drainage angle, to do two things. First it threads a microcatheter around the whole circumference of Schlemm’s canal and gently dilates it with a viscoelastic gel (viscocanaloplasty), reopening the canal and the collector channels. Then it opens 180 degrees of the trabecular meshwork (goniotomy/trabeculotomy). Because it addresses all three sites of resistance — not just the meshwork — and spares the conjunctiva, it offers meaningful pressure and drop reduction while keeping trabeculectomy, Xen or PreserFlo available for the future. In the GEMINI and ROMEO 2 studies, average pressure fell by about 25–30% at two years and medication use roughly halved.
Your options
Your consultant will recommend the approach that matches the stage of your glaucoma, your target pressure and whether you also have a cataract.
Not sure which glaucoma procedure is right for you? A consultant assessment makes it clear.
Book your assessmentHow the procedure works
OMNI is a day-case procedure performed “ab interno” — from inside the eye — under anaesthetic drops, sometimes with a small block. There is no external wound and no bleb.
Before — assessment
Your consultant confirms mild-to-moderate open-angle glaucoma with gonioscopy, OCT of the optic nerve and visual fields, and sets your target pressure. Suitability needs an open drainage angle.
In theatre — 20–30 minutes
Through a 1.6 mm corneal incision and a gonioscopy lens, the microcatheter is threaded around Schlemm’s canal and the canal is dilated with gel; 180 degrees of the meshwork is then opened. If combined with cataract surgery, the lens is replaced first.
Same day — home
You go home the same day with a clear shield and a course of antibiotic and anti-inflammatory drops. No eye patch is usually needed beyond the first few hours.
Recovery
Recovery is fast — markedly quicker than filtration surgery because there is no bleb to manage. A small amount of blood in the front of the eye (hyphaema) is common in the first days and clears on its own. Most patients can read large print and watch television within two to three days, reach their best vision in two to three weeks (or three to six weeks if combined with cataract surgery), and drive within a few days once vision is adequate. Office work usually resumes within a week. Glaucoma needs lifelong monitoring, so reviews continue afterwards. Your drops are reviewed at around four weeks, when many patients can stop one or more.
Cost
At our partner clinics across southern England, standalone OMNI canaloplasty is typically £3,500–£5,500 per eye, all-inclusive of the consultant glaucoma surgeon, the OMNI device, theatre and routine follow-up. Combined with cataract surgery it is usually £4,800–£7,500 per eye (more with a premium toric or extended-depth-of-focus lens). Many patients spread the cost with 0% finance. Book a consultation from £240 for a personalised quote, or see our full price list.
Frequently asked questions
How much does private OMNI canaloplasty cost in the UK?
At our partner clinics in southern England, standalone OMNI canaloplasty is typically £3,500–£5,500 per eye, all-inclusive of the consultant glaucoma surgeon, the OMNI device, day-case theatre and routine follow-up. Combined with cataract surgery it is usually £4,800–£7,500 per eye, rising to £6,500–£9,500 with a premium toric or extended-depth-of-focus lens. Book a consultation from £240 for a personalised quote.
What is OMNI canaloplasty and how does it work?
OMNI (Sight Sciences) is a keyhole procedure that, through one 1.6 mm incision, reopens the eye’s whole natural drainage system. A microcatheter is threaded around the full 360 degrees of Schlemm’s canal and dilates it with a gel, then 180 degrees of the trabecular meshwork is opened. It is the only MIGS that addresses all three points of outflow resistance — the meshwork, the canal and the collector channels — which is why it tends to reduce drops a little more than meshwork-only devices.
How much will my pressure drop, and will I stop my drops?
In the GEMINI and ROMEO 2 studies, average pressure fell by about 25–30% from baseline at 24 months, and medication use roughly halved. Around half to two-thirds of patients were off all glaucoma drops at two years, with most of the rest reduced from two or three drops to one. The realistic goal is materially fewer drops rather than a guarantee of none, and your individual target depends on how much optic-nerve damage you have.
How does OMNI compare to the iStent and Hydrus?
All three are keyhole, angle-based MIGS, but they differ in reach. The iStent inject places two tiny stents across the trabecular meshwork only; the Hydrus is an 8 mm scaffold that opens the meshwork plus about 90 degrees of Schlemm’s canal. OMNI uniquely treats the meshwork, the full 360 degrees of the canal and the collector channels beyond. In 24-month data OMNI tends to give slightly greater drop reduction, but all three are safe and effective; the right choice depends on your anatomy and your surgeon’s assessment.
What is recovery like, and when can I drive?
Recovery is fast because there is no bleb to manage. A little blood in the front of the eye is common early on and clears by itself. Most patients can read large print within two to three days, reach their best vision in two to three weeks (or three to six weeks if combined with cataract surgery), and drive within a few days once vision is adequate and meets the DVLA standard. Office work usually resumes within a week; avoid eye-rubbing, swimming and contact sports for a few weeks.
Does private insurance or the NHS cover OMNI?
Bupa, AXA Health, Aviva, Vitality and WPA all cover OMNI canaloplasty under their standard glaucoma pathways with pre-authorisation — we prepare the package for you. Premium lens upgrades when combined with cataract surgery are usually self-funded. OMNI is also offered on the NHS in selected specialist units under NICE guidance IPG700, but availability is patchy and waits are commonly 6–18 months; the private pathway compresses this to one to four weeks.