Comparison Of Surgical Outcomes Between Excisional Goniotomy Using The Kahook Dual Blade And iStent Trabecular Micro-Bypass Stent In Combination With Phacoemulsification

Dayeong Lee,1 Joshua King,1 Samuel Thomsen,1,2 Matthew Hirabayashi,1 Jella An1,2 1School of Medicine, University of Missouri School of Medicine, Columbia, MO, USA; 2Department of Ophthalmology, Mason Eye Institute, University of Missouri School of Medicine, Columbia, MO, USACorrespondence: Jella AnM...

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Autores principales:	Lee D, King J, Thomsen S, Hirabayashi M, An J
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	glaucoma intraocular pressure minimally invasive glaucoma surgery iStent Kahook Dual Blade Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/4eed194323af4ad4bd3347a64d47ad43
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spelling	oai:doaj.org-article:4eed194323af4ad4bd3347a64d47ad432021-12-02T04:44:52ZComparison Of Surgical Outcomes Between Excisional Goniotomy Using The Kahook Dual Blade And iStent Trabecular Micro-Bypass Stent In Combination With Phacoemulsification1177-5483https://doaj.org/article/4eed194323af4ad4bd3347a64d47ad432019-10-01T00:00:00Zhttps://www.dovepress.com/comparison-of-surgical-outcomes-between-excisional-goniotomy-using-the-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Dayeong Lee,1 Joshua King,1 Samuel Thomsen,1,2 Matthew Hirabayashi,1 Jella An1,2 1School of Medicine, University of Missouri School of Medicine, Columbia, MO, USA; 2Department of Ophthalmology, Mason Eye Institute, University of Missouri School of Medicine, Columbia, MO, USACorrespondence: Jella AnMason Eye Institute - University Eye Institute East, 3215 Wingate Court, Columbia, MO 65201, USATel +1573-529-1077Fax +1573-884-4868Email anja@health.missouri.eduPurpose: To compare 6-month surgical outcomes of patients who underwent phacoemulsification (Phaco) combined with iStent implantation (iStent) versus excisional goniotomy using Kahook Dual Blade (KDB).Methods: Retrospective comparative case series of 58 iStent-Phaco eyes and 44 KDB-Phaco eyes operated upon by a single surgeon between 2016 and 2018. Preoperative, intraoperative, and postoperative intraocular pressure (IOP) and IOP-lowering medication data were collected. The primary outcome was the proportion of eyes using ≥1 fewer IOP-lowering medication at Month 6 while maintaining IOP ≤ 18 mmHg.Results: Baseline IOP was 17.2 (standard error 0.7) in the KDB-Phaco group using a mean of 1.9 (0.2) medications; at Month 6, mean IOP was 14.8 mmHg P=0.002) on 1.0 (0.2) medications (P<0.002). Baseline IOP was 16.7 (0.4) in the iStent-Phaco group using a mean of 1.4 (0.1) medications; at Month 6, mean IOP was 14.2 mmHg (P<0.002) on 1.4 (0.1) medications P=0.374). Changes in IOP and medications were not significantly different between groups (P>0.05). Significantly more KDB-Phaco eyes than iStent-Phaco eyes (43.2% vs 17.2%, P=0.004) were using ≥1 fewer medications while maintaining IOP ≤18 mmHg at Month 6. Adverse events were uncommon and similar in nature and frequency between groups with the exception that more KDB-Phaco eyes than iStent-Phaco eyes (8 [18.2%] versus 1 [1.7%]) experienced an IOP elevation presumed to be related to steroid use.Conclusion: KDB-Phaco and iStent-Phaco provided comparable IOP and medication reductions. The proportion of eyes able to discontinue 1 or more medications while maintaining IOP ≤ 18 mmHg was significantly greater in eyes undergoing KDB-Phaco.Keywords: glaucoma, intraocular pressure, minimally invasive glaucoma surgery, iStent, Kahook Dual BladeLee DKing JThomsen SHirabayashi MAn JDove Medical Pressarticleglaucomaintraocular pressureminimally invasive glaucoma surgeryiStentKahook Dual BladeOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 13, Pp 2097-2102 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	glaucoma intraocular pressure minimally invasive glaucoma surgery iStent Kahook Dual Blade Ophthalmology RE1-994
spellingShingle	glaucoma intraocular pressure minimally invasive glaucoma surgery iStent Kahook Dual Blade Ophthalmology RE1-994 Lee D King J Thomsen S Hirabayashi M An J Comparison Of Surgical Outcomes Between Excisional Goniotomy Using The Kahook Dual Blade And iStent Trabecular Micro-Bypass Stent In Combination With Phacoemulsification
description	Dayeong Lee,1 Joshua King,1 Samuel Thomsen,1,2 Matthew Hirabayashi,1 Jella An1,2 1School of Medicine, University of Missouri School of Medicine, Columbia, MO, USA; 2Department of Ophthalmology, Mason Eye Institute, University of Missouri School of Medicine, Columbia, MO, USACorrespondence: Jella AnMason Eye Institute - University Eye Institute East, 3215 Wingate Court, Columbia, MO 65201, USATel +1573-529-1077Fax +1573-884-4868Email anja@health.missouri.eduPurpose: To compare 6-month surgical outcomes of patients who underwent phacoemulsification (Phaco) combined with iStent implantation (iStent) versus excisional goniotomy using Kahook Dual Blade (KDB).Methods: Retrospective comparative case series of 58 iStent-Phaco eyes and 44 KDB-Phaco eyes operated upon by a single surgeon between 2016 and 2018. Preoperative, intraoperative, and postoperative intraocular pressure (IOP) and IOP-lowering medication data were collected. The primary outcome was the proportion of eyes using ≥1 fewer IOP-lowering medication at Month 6 while maintaining IOP ≤ 18 mmHg.Results: Baseline IOP was 17.2 (standard error 0.7) in the KDB-Phaco group using a mean of 1.9 (0.2) medications; at Month 6, mean IOP was 14.8 mmHg P=0.002) on 1.0 (0.2) medications (P<0.002). Baseline IOP was 16.7 (0.4) in the iStent-Phaco group using a mean of 1.4 (0.1) medications; at Month 6, mean IOP was 14.2 mmHg (P<0.002) on 1.4 (0.1) medications P=0.374). Changes in IOP and medications were not significantly different between groups (P>0.05). Significantly more KDB-Phaco eyes than iStent-Phaco eyes (43.2% vs 17.2%, P=0.004) were using ≥1 fewer medications while maintaining IOP ≤18 mmHg at Month 6. Adverse events were uncommon and similar in nature and frequency between groups with the exception that more KDB-Phaco eyes than iStent-Phaco eyes (8 [18.2%] versus 1 [1.7%]) experienced an IOP elevation presumed to be related to steroid use.Conclusion: KDB-Phaco and iStent-Phaco provided comparable IOP and medication reductions. The proportion of eyes able to discontinue 1 or more medications while maintaining IOP ≤ 18 mmHg was significantly greater in eyes undergoing KDB-Phaco.Keywords: glaucoma, intraocular pressure, minimally invasive glaucoma surgery, iStent, Kahook Dual Blade
format	article
author	Lee D King J Thomsen S Hirabayashi M An J
author_facet	Lee D King J Thomsen S Hirabayashi M An J
author_sort	Lee D
title	Comparison Of Surgical Outcomes Between Excisional Goniotomy Using The Kahook Dual Blade And iStent Trabecular Micro-Bypass Stent In Combination With Phacoemulsification
title_short	Comparison Of Surgical Outcomes Between Excisional Goniotomy Using The Kahook Dual Blade And iStent Trabecular Micro-Bypass Stent In Combination With Phacoemulsification
title_full	Comparison Of Surgical Outcomes Between Excisional Goniotomy Using The Kahook Dual Blade And iStent Trabecular Micro-Bypass Stent In Combination With Phacoemulsification
title_fullStr	Comparison Of Surgical Outcomes Between Excisional Goniotomy Using The Kahook Dual Blade And iStent Trabecular Micro-Bypass Stent In Combination With Phacoemulsification
title_full_unstemmed	Comparison Of Surgical Outcomes Between Excisional Goniotomy Using The Kahook Dual Blade And iStent Trabecular Micro-Bypass Stent In Combination With Phacoemulsification
title_sort	comparison of surgical outcomes between excisional goniotomy using the kahook dual blade and istent trabecular micro-bypass stent in combination with phacoemulsification
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/4eed194323af4ad4bd3347a64d47ad43
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Comparison Of Surgical Outcomes Between Excisional Goniotomy Using The Kahook Dual Blade And iStent Trabecular Micro-Bypass Stent In Combination With Phacoemulsification

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