Outcomes of Phacoemulsification With or Without Kahook Dual Blade Goniotomy for Glaucoma Patients With Cataract.
Radwan Loubna, El Jalbout Jana Dib, Trad Khalid, Radwan Lama, El Zein Lulwa, Brearley Ann, Jiang Ziou, Chanbour Wassef
AI Summary
This study found combining phacoemulsification with KDB goniotomy significantly lowers IOP and medication use more than phacoemulsification alone in glaucoma patients, offering a superior surgical option.
Abstract
Précis: This meta-analysis examines the comparative efficacy of phacoemulsification with and without Kahook Dual Blade Goniotomy in individuals with glaucoma and cataract, aiming to elucidate optimal surgical approaches for coexisting conditions.
Purpose
The purpose of this current study is to compare the effect of combining Kahook Dual Blade (KDB) goniotomy with phacoemulsification versus phacoemulsification alone on intraocular pressure (IOP) and medication reduction in patients with glaucoma and cataract.
Methods
We conducted a systematic review and meta-analysis utilizing computer databases, including Embase (OVID), MEDLINE (OVID and PubMed), CINHAL (EBSCO), and the Cochrane Library (Wiley). We included studies examining the IOP-lowering effect of KDB goniotomy combined with phacoemulsification and studies that examined the IOP-lowering effect of phacoemulsification alone in patients with open angle glaucoma or ocular hypertension. The mean reduction of IOP and the reduction in topical glaucoma eye drops after surgery were determined.
Results
A total of 26 studies were included, reporting on 1659 patients, 684 patients underwent phacoemulsification alone, and 975 underwent combined phacoemulsification and KDB goniotomy. A 9.62% IOP reduction from baseline occurred following phacoemulsification as a solo procedure compared with 22.74% following combined KDB goniotomy with phacoemulsification. Similarly, the combination of the procedures caused a significant drop in the mean number of glaucoma eye drops used [mean reduction=1.35, 95% CI (1.08, 1.61)] compared with phacoemulsification alone [mean reduction=0.36, 95% CI (0.06, 0.66)]. Funnel plots suggested the absence of publication bias.
Conclusions
Both phacoemulsification alone or combined with KDB goniotomy result in a significant decrease in post-op IOP and topical glaucoma eye drops. The combination of these 2 procedures outperforms phacoemulsification alone in terms of both parameters.
MeSH Terms
Shields Classification
Key Concepts4
A meta-analysis of 26 studies (1659 patients) found that phacoemulsification alone resulted in a 9.62% IOP reduction from baseline in patients with glaucoma and cataract.
A meta-analysis of 26 studies (1659 patients) found that combined Kahook Dual Blade (KDB) goniotomy with phacoemulsification resulted in a 22.74% IOP reduction from baseline in patients with glaucoma and cataract.
A meta-analysis of 26 studies (1659 patients) found that combined Kahook Dual Blade (KDB) goniotomy with phacoemulsification caused a significant drop in the mean number of glaucoma eye drops used [mean reduction=1.35, 95% CI (1.08, 1.61)] compared with phacoemulsification alone [mean reduction=0.36, 95% CI (0.06, 0.66)] in patients with glaucoma and cataract.
A systematic review and meta-analysis of 26 studies (1659 patients) concluded that both phacoemulsification alone or combined with Kahook Dual Blade (KDB) goniotomy result in a significant decrease in post-op IOP and topical glaucoma eye drops, with the combination outperforming phacoemulsification alone in terms of both parameters.
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