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Abstract #91494 Published in IGR 21-4

Two-Year Clinical Outcomes of Combined Phacoemulsification, Goniosynechialysis, and Excisional Goniotomy For Angle-Closure Glaucoma

Dorairaj S; Tam MD; Balasubramani GK
Asia-Pacific journal of ophthalmology (Philadelphia, Pa.) 2020; 10: 183-187

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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.

Department of Ophthalmology, Mayo Clinic, Jacksonville, FL, USA.

Full article

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Classification:

12.14.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.14 Combined cataract extraction and glaucoma surgery)
12.9 Trabeculotomy, goniotomy (Part of: 12 Surgical treatment)

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