Phacoemulsification combined with Kahook Dual Blade Goniotomy versus with Trabectome in the treatment of open angle glaucoma.
Mou Dapeng, Wang Jin, Wang Huaizhou, Wang Ningli
AI Summary
This study compared Phaco-KDB and Phaco-Trabectome for open-angle glaucoma. Both surgeries significantly reduced IOP and medication use with similar effectiveness, offering comparable options for patients.
Abstract
To compare the surgical effectiveness and safety of phacoemulsification combined with KDB (Phaco-KDB) and with Trabectome (Phaco-Trabectome) at 6 months follow-up in patients with open-angle glaucoma (OAG)
Methods
This comparative case series was conducted at Beijing Tongren Hospital, including patients diagnosed with OAG who underwent Phaco-KDB from November 2021 to April 2022 and Phaco-Trabectome from April 2017 to December 2017. Surgical success was defined as an IOP reduction ≥ 20% or a postoperative IOP ≤ 21 mmHg. Kaplan-Meier methods were used to calculate cumulative rates of success among groups
Results
A total of 35 eyes from 29 patients were included in the analysis. At 6-month, Both groups exhibited a significant reduction in IOP and the number of IOP-lowering medications compared to preoperative (P=0.01 and P<0.01, respectively). There were no significant differences among groups in terms of reducing IOP and the number of IOP-lowering medications (all P values<0.05). In the Phaco-KDB and Phaco-Trabectome groups, 53.8% and 45.0% of patients achieved an IOP reduction of ≥ 20%, while 92.3% and 85% achieved a mean IOP ≤ 21 mmHg 6 months after surgery. The incidence of IOP spike was 20%, and 3 eyes (8.6%) needed further surgery to control the IOP
Conclusions
Both Phaco-KDB and Phaco-Trabectome demonstrate a significant reduction in IOP and the number of IOP-lowering medications. Phaco-Trabectome appears to provide a more predictable postoperative course in the early postoperative period compared to Phaco-KDB, and the postoperative mean IOP is lower in Phaco-KDB compared to Phaco-Trabectome, despite not being statistically significant.
MeSH Terms
Shields Classification
Key Concepts6
At 6-month follow-up, both Phacoemulsification combined with Kahook Dual Blade Goniotomy (Phaco-KDB) and Phacoemulsification combined with Trabectome (Phaco-Trabectome) groups exhibited a significant reduction in intraocular pressure (IOP) and the number of IOP-lowering medications compared to preoperative values (P=0.01 and P<0.01, respectively) in patients with open-angle glaucoma.
At 6 months after surgery, in the Phacoemulsification combined with Kahook Dual Blade Goniotomy (Phaco-KDB) group, 53.8% of patients achieved an IOP reduction of ≥ 20%, while 92.3% achieved a mean IOP ≤ 21 mmHg. In the Phacoemulsification combined with Trabectome (Phaco-Trabectome) group, 45.0% of patients achieved an IOP reduction of ≥ 20%, while 85% achieved a mean IOP ≤ 21 mmHg.
There were no significant differences between the Phacoemulsification combined with Kahook Dual Blade Goniotomy (Phaco-KDB) and Phacoemulsification combined with Trabectome (Phaco-Trabectome) groups in terms of reducing intraocular pressure (IOP) and the number of IOP-lowering medications (all P values<0.05) at 6-month follow-up in patients with open-angle glaucoma.
Phacoemulsification combined with Trabectome (Phaco-Trabectome) appears to provide a more predictable postoperative course in the early postoperative period compared to Phacoemulsification combined with Kahook Dual Blade Goniotomy (Phaco-KDB), and the postoperative mean IOP is lower in Phaco-KDB compared to Phaco-Trabectome, despite not being statistically significant.
A comparative case series was conducted at Beijing Tongren Hospital, including patients diagnosed with open-angle glaucoma (OAG) who underwent Phaco-KDB from November 2021 to April 2022 and Phaco-Trabectome from April 2017 to December 2017.
The incidence of IOP spike was 20% in the combined Phacoemulsification combined with Kahook Dual Blade Goniotomy (Phaco-KDB) and Phacoemulsification combined with Trabectome (Phaco-Trabectome) groups, and 3 eyes (8.6%) needed further surgery to control the IOP.
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