Outcome of phacoemulsification combined with excisional goniotomy using the Kahook Dual Blade in severe glaucoma patients at 6 months

Matthew T Hirabayashi, Joshua T King, Dayeong Lee, Jella A An Mason Eye Institute, University of Missouri School of Medicine, Columbia, MO 65201, USA Purpose: The aim of this study was to describe 6-month rates of achieving target IOP without requiring additional glaucoma surgery after excisional go...

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Autores principales:	Hirabayashi MT, King JT, Lee D, An JA
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	glaucoma goniotomy intraocular pressure Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/692690c991614ff590240daa47fefc62
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spelling	oai:doaj.org-article:692690c991614ff590240daa47fefc622021-12-02T02:17:04ZOutcome of phacoemulsification combined with excisional goniotomy using the Kahook Dual Blade in severe glaucoma patients at 6 months1177-5483https://doaj.org/article/692690c991614ff590240daa47fefc622019-04-01T00:00:00Zhttps://www.dovepress.com/outcome-of-phacoemulsification-combined-with-excisional-goniotomy-usin-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Matthew T Hirabayashi, Joshua T King, Dayeong Lee, Jella A An Mason Eye Institute, University of Missouri School of Medicine, Columbia, MO 65201, USA Purpose: The aim of this study was to describe 6-month rates of achieving target IOP without requiring additional glaucoma surgery after excisional goniotomy using the Kahook Dual Blade combined with phacoemulsification (phaco-KDB) in patients with severe-stage glaucoma.Methods: Retrospective review of 42 eyes from 36 patients with severe glaucoma who received phaco-KDB. Primary and secondary open-angle and combined-mechanism glaucoma were included. Preoperative, intraoperative, and postoperative data were collected through the 6-month follow-up period. The primary outcome was proportion of patients achieving IOP ≤15 mmHg without additional glaucoma procedures. Secondary outcomes were mean change in IOP, reduction of glaucoma medications, additional glaucoma procedures needed, and adverse events.Results: Preoperative baseline mean IOP was 17.1±4.8 mmHg (mean ± SD) and number of medications was 2.4±1.3. At 6 months, 64.3% (27/42) of eyes had achieved IOP ≤15 mmHg without additional glaucoma procedures, 45.2% (19/42) reached this target IOP on fewer medications, and 31.0% (13/42) on no medications. Mean IOP reduction was 2.1±4.67 mmHg (P=0.022) and mean medication reduction was 1.2±1.4 (P≤0.001). Visually significant complications were experienced by 7.1% (3/42) of eyes, and 7.1% (3/42) required additional IOP-lowering procedures within 6 months of surgery.Conclusion: Patients with severe-stage open-angle glaucoma achieved significant IOP and medication reductions following phaco-KDB. Notably, about two-thirds of eyes achieved an IOP of ≤15 mmHg at 6 months without additional glaucoma procedures. Complications and need for additional procedures were rare. Phaco-KDB may be an effective and safe alternative to more invasive filtering surgery in many patients with severe glaucoma. Keywords: glaucoma, goniotomy, IOPHirabayashi MTKing JTLee DAn JADove Medical Pressarticleglaucomagoniotomyintraocular pressureOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 13, Pp 715-721 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	glaucoma goniotomy intraocular pressure Ophthalmology RE1-994
spellingShingle	glaucoma goniotomy intraocular pressure Ophthalmology RE1-994 Hirabayashi MT King JT Lee D An JA Outcome of phacoemulsification combined with excisional goniotomy using the Kahook Dual Blade in severe glaucoma patients at 6 months
description	Matthew T Hirabayashi, Joshua T King, Dayeong Lee, Jella A An Mason Eye Institute, University of Missouri School of Medicine, Columbia, MO 65201, USA Purpose: The aim of this study was to describe 6-month rates of achieving target IOP without requiring additional glaucoma surgery after excisional goniotomy using the Kahook Dual Blade combined with phacoemulsification (phaco-KDB) in patients with severe-stage glaucoma.Methods: Retrospective review of 42 eyes from 36 patients with severe glaucoma who received phaco-KDB. Primary and secondary open-angle and combined-mechanism glaucoma were included. Preoperative, intraoperative, and postoperative data were collected through the 6-month follow-up period. The primary outcome was proportion of patients achieving IOP ≤15 mmHg without additional glaucoma procedures. Secondary outcomes were mean change in IOP, reduction of glaucoma medications, additional glaucoma procedures needed, and adverse events.Results: Preoperative baseline mean IOP was 17.1±4.8 mmHg (mean ± SD) and number of medications was 2.4±1.3. At 6 months, 64.3% (27/42) of eyes had achieved IOP ≤15 mmHg without additional glaucoma procedures, 45.2% (19/42) reached this target IOP on fewer medications, and 31.0% (13/42) on no medications. Mean IOP reduction was 2.1±4.67 mmHg (P=0.022) and mean medication reduction was 1.2±1.4 (P≤0.001). Visually significant complications were experienced by 7.1% (3/42) of eyes, and 7.1% (3/42) required additional IOP-lowering procedures within 6 months of surgery.Conclusion: Patients with severe-stage open-angle glaucoma achieved significant IOP and medication reductions following phaco-KDB. Notably, about two-thirds of eyes achieved an IOP of ≤15 mmHg at 6 months without additional glaucoma procedures. Complications and need for additional procedures were rare. Phaco-KDB may be an effective and safe alternative to more invasive filtering surgery in many patients with severe glaucoma. Keywords: glaucoma, goniotomy, IOP
format	article
author	Hirabayashi MT King JT Lee D An JA
author_facet	Hirabayashi MT King JT Lee D An JA
author_sort	Hirabayashi MT
title	Outcome of phacoemulsification combined with excisional goniotomy using the Kahook Dual Blade in severe glaucoma patients at 6 months
title_short	Outcome of phacoemulsification combined with excisional goniotomy using the Kahook Dual Blade in severe glaucoma patients at 6 months
title_full	Outcome of phacoemulsification combined with excisional goniotomy using the Kahook Dual Blade in severe glaucoma patients at 6 months
title_fullStr	Outcome of phacoemulsification combined with excisional goniotomy using the Kahook Dual Blade in severe glaucoma patients at 6 months
title_full_unstemmed	Outcome of phacoemulsification combined with excisional goniotomy using the Kahook Dual Blade in severe glaucoma patients at 6 months
title_sort	outcome of phacoemulsification combined with excisional goniotomy using the kahook dual blade in severe glaucoma patients at 6 months
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/692690c991614ff590240daa47fefc62
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Outcome of phacoemulsification combined with excisional goniotomy using the Kahook Dual Blade in severe glaucoma patients at 6 months

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