Effect of combined goniotomy and phacoemulsification on intraocular pressure in open-angle glaucoma patients.
Kim Woo-Jin, Kim Ju-Mi, Lee Woo-Hyuk, Kim Kyoung Nam, Kim Chang-Sik
AI Summary
Combined goniotomy and cataract surgery for open-angle glaucoma significantly reduced intraocular pressure and medication use more than cataract surgery alone, offering a safe, effective treatment option.
Abstract
Importance
Although goniotomy is known to be successful in treating congenital glaucoma, its effect in adult glaucoma patients remains unclear.
Background
To evaluate the efficacy and safety of goniotomy performed simultaneously with cataract surgery in treatment of open-angle glaucoma (OAG).
Design
Retrospective comparative study.
Participants
A total of 76 patients with moderately controlled OAG (intraocular pressure [IOP] ≤ 21 mmHg using medications) undergoing cataract surgery.
Methods
Comparison of patients who underwent the conventional goniotomy during cataract surgery (combined goniotomy group) with those who underwent cataract surgery alone (phaco group).
Main outcome measures
Changes in IOP and medications, and complications through 12 months.
Results
Baseline IOP was 18.2 ± 2.4 mmHg in the combined goniotomy group and 17.4 ± 1.9 mmHg in the phaco group; number of medications was 2.6 ± 1.1 and 2.4 ± 0.9, respectively (P > 0.05). The reduction in IOP and medication use from baseline in the combined goniotomy group was significantly greater at 12 months compared to the phaco group (-3.1 ± 2.9 mmHg vs -1.3 ± 2.4 mmHg and -1.2 ± 0.9 vs -0.7 ± 0.9, respectively, both P < 0.05). The success rate was 76.7% in the combined goniotomy group and 50.0% in the phaco group at 12 months (P = 0.021). No significant complication was observed in either group.
Conclusions and relevance: Combined goniotomy and cataract surgery showed a significantly greater reduction in IOP and number of medications compared to cataract surgery alone at 1 year after surgery, with similarly favourable safety profiles.
MeSH Terms
Shields Classification
Key Concepts4
In a retrospective comparative study of 76 patients with moderately controlled open-angle glaucoma (IOP ≤ 21 mmHg using medications) undergoing cataract surgery, the combined goniotomy and cataract surgery group showed a significantly greater reduction in intraocular pressure (IOP) at 12 months compared to the cataract surgery alone group (-3.1 ± 2.9 mmHg vs -1.3 ± 2.4 mmHg, P < 0.05).
In a retrospective comparative study of 76 patients with moderately controlled open-angle glaucoma (IOP ≤ 21 mmHg using medications) undergoing cataract surgery, the combined goniotomy and cataract surgery group showed a significantly greater reduction in medication use at 12 months compared to the cataract surgery alone group (-1.2 ± 0.9 vs -0.7 ± 0.9, P < 0.05).
In a retrospective comparative study of 76 patients with moderately controlled open-angle glaucoma (IOP ≤ 21 mmHg using medications) undergoing cataract surgery, the success rate at 12 months was 76.7% in the combined goniotomy and cataract surgery group and 50.0% in the cataract surgery alone group (P = 0.021).
In a retrospective comparative study comparing combined goniotomy and cataract surgery with cataract surgery alone in 76 patients with moderately controlled open-angle glaucoma, no significant complications were observed in either group.
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