Complicated trabeculectomy converted into ab externo cyclodialysis

Abstract

The purpose of this study was to investigate the postoperative outcomes and evaluate the success predictors of phacoemulsification with Kahook Dual Blade goniotomy for cataract and glaucoma management in eyes with primary open-angle glaucoma.Methods: This was a retrospective, non-comparative; interventional case series in which all patients with primary open-angle glaucoma who underwent phacoemulsification with Kahook Dual Blade goniotomy between June 2018 and April 2019 were enrolled. All the participants had a minimum follow-up period of 6 months. Preoperative and postoperative intraocular pressure values (at 1, 3, and 6 months), number of antiglaucoma medications, best-corrected visual acuity, surgical complications, and any subsequent related events or procedures were recorded. A logistic regression analysis was performed to investigate the association between the different variables and surgical outcomes.Results: A total of 47 patients (57 eyes) were included (mean age, 70.5 ± 7 years). The mean intraocular pressure was reduced from 15.5 ± 4.2 mmHg to 12.2 ± 2.4 mmHg at the last follow-up visit (p<0.001). The mean number of antiglaucoma medications decreased significantly from 1.9 ± 1.0 to 0.6 ± 1.0 during the same period (p<0.001). On the basis of the predefined criterion (intraocular pressure reduction ≥20% and/or reduction ≥1 medication), the 6-month success rate was 86%. A higher preoperative intraocular pressure value (odds ratio [OR]= 2.01; p=0.016) and greater percentage of initial (30 days) intraocular pressure reduction (OR= 1.02; p=0.033) were sig nificantly associated with surgical success. Conclusion: Our findings suggest that phacoemulsification with Kahook Dual Blade goniotomy is an effective and safe alternative for cataract management in eyes with primary open-angle glaucoma that positively impacts intraocular pressure control and medication burden. Eyes with higher baseline intraocular pressure and a more pronounced initial response to the procedure appeared to present better outcomes at 6 months. Further studies are needed to evaluate the long-term efficacy and safety profile of the procedure.

Twelve-month outcomes of Kahook Dual Blade goniotomy combined with cataract surgery in Latino patients

“…In a recent retrospective study that evaluated the results of the KDB goniotomy combined with cataract extraction in 57 eyes of 47 patients from Brazil, over a period of 6 months, the number of eyes achieving 20% IOP reduction and/or reduction of at least one medication was 86%. Furthermore, the number of topical medications was reduced from 1.9 ± 1.0 at baseline to 0.6 ± 1.0 (p < 0.001) at the last visit [22]. Laroche et al also reported 6-months follow-up results after goniotomy with the KDB either combined with cataract extraction or as stand-alone procedure in Black and Afro-Latinx patients.…”

15 years of minimally-invasive glaucoma surgeries (MIGS) experience and data: a rationale for optimal clinical decision-making

“…The efficacy and safety of MIGS have been extensively investigated over the past few years (9)(10)(11)(12)(13)(14)(15)(16) . However, considerable variability and uncertainty remain worldwide regarding their effective application in clinical practice, leading to suboptimal patient selection and outcomes.…”