Gonioscopy-assisted transluminal trabeculotomy versus goniotomy with Kahook dual blade in patients with uncontrolled juvenile open-angle glaucoma: a retrospective study

Abstract Background To compare the efficacy and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) and Kahook Dual Blade (KDB) excisional goniotomy in patients with uncontrolled juvenile open-angle glaucoma (JOAG). Methods Thirty-three patients (46 eyes) were included in this single-cen...

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Autores principales:	Yunsheng Qiao, Chen Tan, Xueli Chen, Xinghuai Sun, Junyi Chen
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Kahook dual blade Gonioscopy-assisted transluminal trabeculotomy Juvenile open-angle glaucoma Minimally invasive glaucoma surgery Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/e82eb2c6e08845a39b96b97302cfe623
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spelling	oai:doaj.org-article:e82eb2c6e08845a39b96b97302cfe6232021-11-21T12:42:56ZGonioscopy-assisted transluminal trabeculotomy versus goniotomy with Kahook dual blade in patients with uncontrolled juvenile open-angle glaucoma: a retrospective study10.1186/s12886-021-02159-z1471-2415https://doaj.org/article/e82eb2c6e08845a39b96b97302cfe6232021-11-01T00:00:00Zhttps://doi.org/10.1186/s12886-021-02159-zhttps://doaj.org/toc/1471-2415Abstract Background To compare the efficacy and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) and Kahook Dual Blade (KDB) excisional goniotomy in patients with uncontrolled juvenile open-angle glaucoma (JOAG). Methods Thirty-three patients (46 eyes) were included in this single-center, retrospective, comparative study and treated with GATT (36 eyes) or KDB goniotomy (13 eyes). Intraocular pressure (IOP), number of glaucoma medications, adverse events, and additional anti-glaucoma procedures were collected during pre- and postoperative visits. Surgical success was defined as 6 mmHg ≤ IOP ≤ 18 mmHg and ≥ 20% IOP reduction from baseline with (partial success) or without (complete success) IOP-lowering medications. Results The mean ± SD preoperative IOP was 30.48 ± 12.9 mmHg and 26.08 ± 13.1 mmHg (P = 0.164) on 3.71 ± 0.46 and 3.08 ± 0.86 (P = 0.023) glaucoma medications in GATT and KDB group, respectively. At 3 months, the mean ± SD IOP was 15.48 ± 5.93 mmHg and 20.0 ± 10.8 mmHg after GATT and KDB, respectively (P = 0.072). The percentage of IOP lowering from baseline was 44.4 in the GATT group and 14.1 in the KDB group (P = 0.011). The mean reduction in medications was 2.6 ± 1.7 and 0.8 ± 1.2 three months after GATT and KDB, respectively (P < 0.001). Cumulative proportion of partial and complete success were 65.6 and 44.7% in the GATT group, 30.8 and 15.4% in the KDB group at 6 months. Additional procedures were required in 13.9% of cases after GATT and in 61.5% after KDB (P = 0.001). Patients in the GATT group with prior anti-glaucoma procedures and postoperative IOP spikes were more likely to fail, while those with complete trabeculotomy had a better prognosis. Conclusions Reduction of IOP and medications were greater after GATT in uncontrolled JOAG eyes. Whereas, more additional IOP-lowering procedures were required after KDB goniotomy. Trial registration This study was registered under the Chinese Clinical Trial Registry ( ChiCTR2000034172 , 27/06/2020).Yunsheng QiaoChen TanXueli ChenXinghuai SunJunyi ChenBMCarticleKahook dual bladeGonioscopy-assisted transluminal trabeculotomyJuvenile open-angle glaucomaMinimally invasive glaucoma surgeryOphthalmologyRE1-994ENBMC Ophthalmology, Vol 21, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Kahook dual blade Gonioscopy-assisted transluminal trabeculotomy Juvenile open-angle glaucoma Minimally invasive glaucoma surgery Ophthalmology RE1-994
spellingShingle	Kahook dual blade Gonioscopy-assisted transluminal trabeculotomy Juvenile open-angle glaucoma Minimally invasive glaucoma surgery Ophthalmology RE1-994 Yunsheng Qiao Chen Tan Xueli Chen Xinghuai Sun Junyi Chen Gonioscopy-assisted transluminal trabeculotomy versus goniotomy with Kahook dual blade in patients with uncontrolled juvenile open-angle glaucoma: a retrospective study
description	Abstract Background To compare the efficacy and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) and Kahook Dual Blade (KDB) excisional goniotomy in patients with uncontrolled juvenile open-angle glaucoma (JOAG). Methods Thirty-three patients (46 eyes) were included in this single-center, retrospective, comparative study and treated with GATT (36 eyes) or KDB goniotomy (13 eyes). Intraocular pressure (IOP), number of glaucoma medications, adverse events, and additional anti-glaucoma procedures were collected during pre- and postoperative visits. Surgical success was defined as 6 mmHg ≤ IOP ≤ 18 mmHg and ≥ 20% IOP reduction from baseline with (partial success) or without (complete success) IOP-lowering medications. Results The mean ± SD preoperative IOP was 30.48 ± 12.9 mmHg and 26.08 ± 13.1 mmHg (P = 0.164) on 3.71 ± 0.46 and 3.08 ± 0.86 (P = 0.023) glaucoma medications in GATT and KDB group, respectively. At 3 months, the mean ± SD IOP was 15.48 ± 5.93 mmHg and 20.0 ± 10.8 mmHg after GATT and KDB, respectively (P = 0.072). The percentage of IOP lowering from baseline was 44.4 in the GATT group and 14.1 in the KDB group (P = 0.011). The mean reduction in medications was 2.6 ± 1.7 and 0.8 ± 1.2 three months after GATT and KDB, respectively (P < 0.001). Cumulative proportion of partial and complete success were 65.6 and 44.7% in the GATT group, 30.8 and 15.4% in the KDB group at 6 months. Additional procedures were required in 13.9% of cases after GATT and in 61.5% after KDB (P = 0.001). Patients in the GATT group with prior anti-glaucoma procedures and postoperative IOP spikes were more likely to fail, while those with complete trabeculotomy had a better prognosis. Conclusions Reduction of IOP and medications were greater after GATT in uncontrolled JOAG eyes. Whereas, more additional IOP-lowering procedures were required after KDB goniotomy. Trial registration This study was registered under the Chinese Clinical Trial Registry ( ChiCTR2000034172 , 27/06/2020).
format	article
author	Yunsheng Qiao Chen Tan Xueli Chen Xinghuai Sun Junyi Chen
author_facet	Yunsheng Qiao Chen Tan Xueli Chen Xinghuai Sun Junyi Chen
author_sort	Yunsheng Qiao
title	Gonioscopy-assisted transluminal trabeculotomy versus goniotomy with Kahook dual blade in patients with uncontrolled juvenile open-angle glaucoma: a retrospective study
title_short	Gonioscopy-assisted transluminal trabeculotomy versus goniotomy with Kahook dual blade in patients with uncontrolled juvenile open-angle glaucoma: a retrospective study
title_full	Gonioscopy-assisted transluminal trabeculotomy versus goniotomy with Kahook dual blade in patients with uncontrolled juvenile open-angle glaucoma: a retrospective study
title_fullStr	Gonioscopy-assisted transluminal trabeculotomy versus goniotomy with Kahook dual blade in patients with uncontrolled juvenile open-angle glaucoma: a retrospective study
title_full_unstemmed	Gonioscopy-assisted transluminal trabeculotomy versus goniotomy with Kahook dual blade in patients with uncontrolled juvenile open-angle glaucoma: a retrospective study
title_sort	gonioscopy-assisted transluminal trabeculotomy versus goniotomy with kahook dual blade in patients with uncontrolled juvenile open-angle glaucoma: a retrospective study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/e82eb2c6e08845a39b96b97302cfe623
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Gonioscopy-assisted transluminal trabeculotomy versus goniotomy with Kahook dual blade in patients with uncontrolled juvenile open-angle glaucoma: a retrospective study

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