Turn Back Elevation of Once Reduced IOP After Trabeculotomy Ab Externo and Kahook Dual Blade Surgeries Combined with Cataract Surgery

Etsuo Chihara,1,2 Tomoyuki Chihara3 1Department of Ophthalmology, Sensho-Kai Eye Institute, Uji, Kyoto, Japan; 2Department of Ophthalmology, Shimane University, Izumo, Shimane, Japan; 3Department of Ophthalmology, Kansai Medical University, Hirakata, Osaka, JapanCorrespondence: Etsuo ChiharaSensho-K...

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Autores principales:	Chihara E, Chihara T
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	migs external trabeculotomy kahook dual blade spike of iop schlemm’s canal surgery Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/4a5fb512e3034a1b8e8ac03db14687ff
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spelling	oai:doaj.org-article:4a5fb512e3034a1b8e8ac03db14687ff2021-12-02T11:43:54ZTurn Back Elevation of Once Reduced IOP After Trabeculotomy Ab Externo and Kahook Dual Blade Surgeries Combined with Cataract Surgery1177-5483https://doaj.org/article/4a5fb512e3034a1b8e8ac03db14687ff2020-12-01T00:00:00Zhttps://www.dovepress.com/turn-back-elevation-of-once-reduced-iop-after-trabeculotomy-ab-externo-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Etsuo Chihara,1,2 Tomoyuki Chihara3 1Department of Ophthalmology, Sensho-Kai Eye Institute, Uji, Kyoto, Japan; 2Department of Ophthalmology, Shimane University, Izumo, Shimane, Japan; 3Department of Ophthalmology, Kansai Medical University, Hirakata, Osaka, JapanCorrespondence: Etsuo ChiharaSensho-Kai Eye Institute, Minamiyama 50-1, Iseda, Uji, Kyoto 611-0043, JapanTel +81-774-45-2060Fax +81-774-45-4565Email chiha492001@gmail.comPurpose: To evaluate the surgical outcome of internal trabeculectomy by Kahook dual blade (KDB) with that of external trabeculotomy, each combined with phaco-lensectomy and intraocular lens implantation (Phaco).Patients and Methods: This is a retrospective comparative study. The primary and secondary outcome measures are postsurgical intraocular pressure and postsurgical hyphema. One eye each of 76 primary open angle glaucoma (POAG), pseudoexfoliation glaucoma (PEG) and ocular hypertension (OH) patients underwent external phaco-trabeculotomy, and that of 40 POAG, PEG and OH patients underwent phaco-KDB surgery.Results: Reduction of the intraocular pressure (IOP) by phaco-KDB at one and two years was 28.4 and 27.8%, respectively, and was not significantly different from that by external phaco-trabeculotomy of 32.7% (P=0.256) and 31.5% (P=0.468), respectively. Three months postsurgical IOP after phaco-KDB and external phaco-trabeculotomy was 16.1 and 15.9 mmHg, respectively. There was a significant turn back elevation of once reduced IOP to 17.1 (P=0.0207) and 17.0 mmHg (P=0.0096) at 24 months, respectively. There were no differences in success probability to achieve IOP below 17 mmHg (P=0.120), 21 mmHg (P=0.719) and > 20% IOP reduction (P=0.309) with medication(s) at two years between the phaco-KDB and external phaco-trabeculotomy cohorts. Younger age was a significant (P< 0.001) risk factor for failure; however, presurgical IOP (P=0.466), the type of surgery (P=0.219) and presence of postsurgical IOP spike (P=0.737) were not significant risk factors by the Cox proportional hazard model. Hyphema and spike of the IOP in phaco-KDB and external phaco-trabeculotomy cohorts were 40% and 88% (P< 0.001), and 53% and 41% (P=0.238), respectively.Conclusion: The IOP reduction by the phaco-KDB was equivalent to that by external phaco-trabeculotomy up to two years. In both cohorts, once reduced postsurgical IOP tend to increase up to 24 months.Keywords: MIGS, external trabeculotomy, Kahook dual blade, spike of IOP, Schlemm’s canal surgeryChihara EChihara TDove Medical Pressarticlemigsexternal trabeculotomykahook dual bladespike of iopschlemm’s canal surgeryOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 4359-4368 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	migs external trabeculotomy kahook dual blade spike of iop schlemm’s canal surgery Ophthalmology RE1-994
spellingShingle	migs external trabeculotomy kahook dual blade spike of iop schlemm’s canal surgery Ophthalmology RE1-994 Chihara E Chihara T Turn Back Elevation of Once Reduced IOP After Trabeculotomy Ab Externo and Kahook Dual Blade Surgeries Combined with Cataract Surgery
description	Etsuo Chihara,1,2 Tomoyuki Chihara3 1Department of Ophthalmology, Sensho-Kai Eye Institute, Uji, Kyoto, Japan; 2Department of Ophthalmology, Shimane University, Izumo, Shimane, Japan; 3Department of Ophthalmology, Kansai Medical University, Hirakata, Osaka, JapanCorrespondence: Etsuo ChiharaSensho-Kai Eye Institute, Minamiyama 50-1, Iseda, Uji, Kyoto 611-0043, JapanTel +81-774-45-2060Fax +81-774-45-4565Email chiha492001@gmail.comPurpose: To evaluate the surgical outcome of internal trabeculectomy by Kahook dual blade (KDB) with that of external trabeculotomy, each combined with phaco-lensectomy and intraocular lens implantation (Phaco).Patients and Methods: This is a retrospective comparative study. The primary and secondary outcome measures are postsurgical intraocular pressure and postsurgical hyphema. One eye each of 76 primary open angle glaucoma (POAG), pseudoexfoliation glaucoma (PEG) and ocular hypertension (OH) patients underwent external phaco-trabeculotomy, and that of 40 POAG, PEG and OH patients underwent phaco-KDB surgery.Results: Reduction of the intraocular pressure (IOP) by phaco-KDB at one and two years was 28.4 and 27.8%, respectively, and was not significantly different from that by external phaco-trabeculotomy of 32.7% (P=0.256) and 31.5% (P=0.468), respectively. Three months postsurgical IOP after phaco-KDB and external phaco-trabeculotomy was 16.1 and 15.9 mmHg, respectively. There was a significant turn back elevation of once reduced IOP to 17.1 (P=0.0207) and 17.0 mmHg (P=0.0096) at 24 months, respectively. There were no differences in success probability to achieve IOP below 17 mmHg (P=0.120), 21 mmHg (P=0.719) and > 20% IOP reduction (P=0.309) with medication(s) at two years between the phaco-KDB and external phaco-trabeculotomy cohorts. Younger age was a significant (P< 0.001) risk factor for failure; however, presurgical IOP (P=0.466), the type of surgery (P=0.219) and presence of postsurgical IOP spike (P=0.737) were not significant risk factors by the Cox proportional hazard model. Hyphema and spike of the IOP in phaco-KDB and external phaco-trabeculotomy cohorts were 40% and 88% (P< 0.001), and 53% and 41% (P=0.238), respectively.Conclusion: The IOP reduction by the phaco-KDB was equivalent to that by external phaco-trabeculotomy up to two years. In both cohorts, once reduced postsurgical IOP tend to increase up to 24 months.Keywords: MIGS, external trabeculotomy, Kahook dual blade, spike of IOP, Schlemm’s canal surgery
format	article
author	Chihara E Chihara T
author_facet	Chihara E Chihara T
author_sort	Chihara E
title	Turn Back Elevation of Once Reduced IOP After Trabeculotomy Ab Externo and Kahook Dual Blade Surgeries Combined with Cataract Surgery
title_short	Turn Back Elevation of Once Reduced IOP After Trabeculotomy Ab Externo and Kahook Dual Blade Surgeries Combined with Cataract Surgery
title_full	Turn Back Elevation of Once Reduced IOP After Trabeculotomy Ab Externo and Kahook Dual Blade Surgeries Combined with Cataract Surgery
title_fullStr	Turn Back Elevation of Once Reduced IOP After Trabeculotomy Ab Externo and Kahook Dual Blade Surgeries Combined with Cataract Surgery
title_full_unstemmed	Turn Back Elevation of Once Reduced IOP After Trabeculotomy Ab Externo and Kahook Dual Blade Surgeries Combined with Cataract Surgery
title_sort	turn back elevation of once reduced iop after trabeculotomy ab externo and kahook dual blade surgeries combined with cataract surgery
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/4a5fb512e3034a1b8e8ac03db14687ff
work_keys_str_mv	AT chiharae turnbackelevationofoncereducediopaftertrabeculotomyabexternoandkahookdualbladesurgeriescombinedwithcataractsurgery AT chiharat turnbackelevationofoncereducediopaftertrabeculotomyabexternoandkahookdualbladesurgeriescombinedwithcataractsurgery
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Turn Back Elevation of Once Reduced IOP After Trabeculotomy Ab Externo and Kahook Dual Blade Surgeries Combined with Cataract Surgery

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