Relationship between selective laser trabeculoplasty and excisional goniotomy outcomes in glaucomatous eyes

King, Joshua; Lee, Dayeong; Thomsen, Samuel; Hirabayashi, Matthew; An, Jella

doi:10.1016/j.jcjo.2021.02.040

Cited by 5 publications

(8 citation statements)

References 29 publications

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“…Interestingly, eyes that did not respond to SLT showed slightly higher rates of subsequent success of phaco/KDB goniotomy surgery (although not statistically significant) between 1 and 6 months follow-up, supporting the potential benefit of KDB goniotomy in patients with a history of failed SLT. These findings are in accordance with results of the only previously published study on this subject by King et al [7]. In their investigation, however, the cohort of eyes included for analysis was smaller (n = 30) and only patients who had 2 months of follow-up after SLT were included.…”

Section: Discussionsupporting

confidence: 91%

“…The juxtacanalicular meshwork layer of the trabecular meshwork (TM) is thought to be the site of greatest resistance to aqueous outflow and the largest contributor to IOP elevation in patients with OAG making it an attractive target for therapeutic intervention [5,6]. Selective laser trabeculoplasty (SLT) is a laser treatment that is thought to act on the TM to increase aqueous outflow through the conventional outflow pathway [7][8][9]. The treatment uses a 532 nm Nd:YAG photodisruptive laser to target the pigmented cells of the TM [9].…”

Section: Introductionmentioning

confidence: 99%

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Selective Laser Trabeculoplasty and Outcomes of Subsequent Phacoemulsification Combined with Kahook Dual Blade Goniotomy

et al. 2022

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Introduction:To investigate the relationship between intraocular pressure (IOP)-lowering success of selective laser trabeculoplasty (SLT) and combined phacoemulsification/Kahook Dual Blade (phaco/KDB) goniotomy in eyes with mild to severe open angle glaucoma (OAG). Methods: Eyes undergoing combined phaco/ KDB goniotomy and that had previously undergone SLT were analyzed. Data collected included demographics, glaucoma type and severity, IOP, and topical IOP-lowering medications before and after both procedures. Eyes were divided into two groups based on success of SLT, defined as IOP reduction of at least 20% maintained on at least two consecutive followup visits without any subsequent medication additions or interventions. Phaco/KDB goniotomy success was defined as IOP reduction of at least 20% and/or reduction in the number of IOP-lowering medications of at least one up to 12 months of follow-up. Results: Overall, SLT was successful in 20 of 43 eyes (46.5%), of which 63.6% (7/11) had successful phaco/KDB goniotomy at 12 months follow-up. Among eyes with unsuccessful SLT, 60.0% (9/15) had successful phaco/KDB at 12 months follow-up. Phaco/KDB success rate was similar in patients regardless of their previous response to SLT at all postoperative time points up to 12 months follow-up (p = 0.87). Conclusions: The presence or lack of IOP-lowering response to SLT did not influence the success rate of subsequent phaco/KDB goniotomy in eyes with mild to severe OAG. Patients who did not respond to SLT still benefited from phaco/KDB goniotomy at a later date.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Selective Laser Trabeculoplasty and Outcomes of Subsequent Phacoemulsification Combined with Kahook Dual Blade Goniotomy

et al. 2022

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“…showed that the outcome of LTP is not predictive of the outcome of subsequent KDB goniotomy [10]. In this study, we sought to determine whether LTP could successfully lower IOP in eyes with prior KDB goniotomy.…”

Section: Discussionmentioning

confidence: 99%

“…A meta-analysis by Zhou et al showed that all available types of LTP are equally effective at decreasing IOP compared to medication-based therapies [ 17 ]. Recently, King et al showed that the outcome of LTP is not predictive of the outcome of subsequent KDB goniotomy [ 10 ]. In this study, we sought to determine whether LTP could successfully lower IOP in eyes with prior KDB goniotomy.…”

Section: Discussionmentioning

confidence: 99%

“…Laser trabeculoplasty (LTP) is frequently offered in patients who had inadequate response to an angle surgery in attempt to further lower IOP or reduce medication burden. King et al recently reported that the outcome of LTP is not predictive of the outcome of subsequent KDB goniotomy, and KDB goniotomy surgery remains to be effective even in eyes with failed LTP [ 10 ]. However, the question of whether LTP could successfully lower IOP in eyes with history of KDB goniotomy still exists, and to our knowledge there is no published data that addresses this question.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Outcomes for Laser Trabeculoplasty after Kahook Dual Blade Goniotomy Versus in Goniotomy-Naive Eyes

et al. 2021

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Introduction: This was a comparison of laser trabeculoplasty (LTP) outcomes in eyes with prior Kahook Dual Blade (KDB) goniotomy versus in goniotomy-naive control eyes. Methods: This was a retrospective matched comparative case series. We identified a cohort of patients undergoing LTP between February 2017 and July 2020 at University of Missouri. Patients were grouped by history of KDB goniotomy versus goniotomy-naivety as a control group. Inclusion criteria included age at least 18 years, minimum of 6 months follow-up after LTP, and minimum period of 6 months between KDB goniotomy and LTP. All KDB procedures were combined with uncomplicated phacoemulsification. Patients who had any additional intraocular pressure (IOP)-lowering procedures between KDB goniotomy and LTP were excluded. Patients in the control group received a single LTP procedure.Primary outcome consisted of the comparison of LTP success, defined as IOP reduction of at least 20% or reduction of glaucoma medications from pre-LTP baseline. Secondary outcomes included IOP and medication reduction from pre-LTP baseline.Results: Twenty-one eyes of 19 patients with history of KDB goniotomy and 42 eyes of 36 control patients without previous angle or laser procedures were included. Baseline characteristics including age, gender, ethnicity, type and severity of glaucoma, baseline IOP, and baseline medications were matched between groups. The LTP success rate was higher in the control group, but was not statistically significant (64% vs 57%, p = 0.58). IOP reduction was only significant in the control eyes (2.50 ± 4.0 mmHg, p = 0.01 vs 2.35 ± 4.7 mmHg, p = 0.08). The number of glaucoma medications was not significantly reduced in either group. Conclusion: LTP may have a limited IOP-and medication-lowering effect in eyes with a history of KDB goniotomy compared to goniotomy-naive eyes.

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Netarsudil as a Predictor of Response for MicroPulse Transscleral Laser Therapy

Lee

Cho

et al. 2022

Ophthalmology Glaucoma

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Relationship between selective laser trabeculoplasty and excisional goniotomy outcomes in glaucomatous eyes

Cited by 5 publications

References 29 publications

Selective Laser Trabeculoplasty and Outcomes of Subsequent Phacoemulsification Combined with Kahook Dual Blade Goniotomy

Selective Laser Trabeculoplasty and Outcomes of Subsequent Phacoemulsification Combined with Kahook Dual Blade Goniotomy

Comparison of Outcomes for Laser Trabeculoplasty after Kahook Dual Blade Goniotomy Versus in Goniotomy-Naive Eyes

Netarsudil as a Predictor of Response for MicroPulse Transscleral Laser Therapy

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