Two-Year Clinical Outcomes of Combined Phacoemulsification, Goniosynechialysis, and Excisional Goniotomy For Angle-Closure Glaucoma.
Dorairaj Syril, Tam Mai Dang, Balasubramani Goundappa K
AI Summary
This study found combined cataract surgery and angle procedures significantly lowered IOP and medication use for angle-closure glaucoma over two years, offering a sustained, effective treatment.
Abstract
Purpose
The aim of this study was to describe changes in intraocular pressure (IOP) and IOP medications after phacoemulsification with Kahook Dual Blade-assisted goniosynechialysis and excisional goniotomy in eyes with angle-closure glaucoma and cataract.
Design
Retrospective case series.
Methods
Data were collected retrospectively through 24 months of follow-up in 42 eyes of 24 subjects.
Results
Preoperative mean (SE) IOP was 25.5 (0.7) mm Hg using a mean of 2.3 (0.1) medications per eye. At month 24, mean IOP had decreased to 13.5 (0.4) mm Hg [a reduction of 12.0 mm Hg (47.1%); P < 0.0001]. Medication use declined to a mean of 0.6 (0.2) medications per eye [a reduction of 1.7 medications per eye (76%); P < 0.0001]. At month 24, 40 of 42 eyes (95.2%) achieved IOP ≤18 mm Hg, 42 of 42 eyes (100%) achieved IOP reduction of ≥20%, 36 of 42 eyes (85.7%) required ≥1 fewer medications for IOP control, and 29 of 42 (69.0%) were medication-free. No eyes required additional glaucoma surgery throughout 24 months of follow-up.
Conclusions
Phaco plus Kahook Dual Blade-assisted goniosynechialysis/excisional goniotomy provides statistically and clinically meaningful reductions in both IOP and medications in eyes with angle-closure glaucoma throughout 2 years of follow-up. These findings are consistent with our previously reported outcomes in this cohort at months 6 and 12 postoperatively, demonstrating a significant and sustained benefit of this procedure in eyes with angle-closure glaucoma and cataract.
MeSH Terms
Shields Classification
Key Concepts6
In a retrospective case series of 42 eyes of 24 subjects with angle-closure glaucoma and cataract, combined phacoemulsification, goniosynechialysis, and excisional goniotomy reduced mean intraocular pressure (IOP) from a preoperative mean (SE) of 25.5 (0.7) mm Hg to 13.5 (0.4) mm Hg at month 24, a reduction of 12.0 mm Hg (47.1%) (P<0.0001).
In a retrospective case series of 42 eyes of 24 subjects with angle-closure glaucoma and cataract, combined phacoemulsification, goniosynechialysis, and excisional goniotomy reduced mean IOP medication use from a preoperative mean of 2.3 (0.1) medications per eye to 0.6 (0.2) medications per eye at month 24, a reduction of 1.7 medications per eye (76%) (P<0.0001).
At month 24, after combined phacoemulsification, goniosynechialysis, and excisional goniotomy in 42 eyes of 24 subjects with angle-closure glaucoma and cataract, 40 of 42 eyes (95.2%) achieved IOP ≤18 mm Hg.
At month 24, after combined phacoemulsification, goniosynechialysis, and excisional goniotomy in 42 eyes of 24 subjects with angle-closure glaucoma and cataract, 42 of 42 eyes (100%) achieved an IOP reduction of ≥20%.
At month 24, after combined phacoemulsification, goniosynechialysis, and excisional goniotomy in 42 eyes of 24 subjects with angle-closure glaucoma and cataract, 29 of 42 eyes (69.0%) were medication-free.
No eyes required additional glaucoma surgery throughout 24 months of follow-up after combined phacoemulsification, goniosynechialysis, and excisional goniotomy in 42 eyes of 24 subjects with angle-closure glaucoma and cataract.
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