Phacoemulsification with Kahook Dual Blade goniotomy in eyes with medically treated glaucoma: analysis of surgical outcomes and success predictors

• Published in: Arquivos brasileiros de oftalmologia Vol. 85; no. 4; pp. 359 - 363
• Main Authors: Ibrahim, Larissa Fouad, Pereira, Anna Flavia Ribeiro, Terenzi, Larissa Alves de Oliveira, Vianello, Marcos Pereira, Dorairaj, Syril Kumar, Prata, Tiago Santos, Kanadani, Fabio Nishimura
• Format: Journal Article
• Language: English
• Published: Conselho Brasileiro de Oftalmologia 2022
• Subjects: OPHTHALMOLOGY; Glaucoma; Glaucoma de ângulo aberto; Facoemulsificação; Cataract; Glaucoma, open angle; Goniotomia; Goniotomy; Pressão intraocular; Phacoe mulsification; Catarata; Intraocular pressure
• ISSN: 0004-2749; 1678-2925; 1678-2925
• DOI: 10.5935/0004-2749.20220046

PURPOSEThe purpose of this study was to investigate the postoperative outcomes and evaluate the success predictors of phacoemulsification with Kahook Dual Blade goniotomy for cataract and glaucoma management in eyes with primary open-angle glaucoma. METHODSThis was a retrospective, non-comparative; inter ventional case series in which all patients with primary open-angle glaucoma who underwent phacoemulsification with Kahook Dual Blade goniotomy between June 2018 and April 2019 were enrolled. All the participants had a minimum follow-up period of 6 months. Preoperative and postoperative intraocular pressure values (at 1, 3, and 6 months), number of antiglaucoma medications, best-corrected visual acuity, surgical complications, and any subsequent related events or procedures were recorded. A logistic regression analysis was performed to investigate the association between the different variables and surgical outcomes. RESULTSA total of 47 patients (57 eyes) were included (mean age, 70.5 ± 7 years). The mean intraocular pressure was reduced from 15.5 ± 4.2 mmHg to 12.2 ± 2.4 mmHg at the last follow-up visit (p<0.001). The mean number of antiglaucoma medications decreased significantly from 1.9 ± 1.0 to 0.6 ± 1.0 during the same period (p<0.001). On the basis of the predefined criterion (intraocular pressure reduction ≥20% and/or reduction ≥1 medication), the 6-month success rate was 86%. A higher preoperative intraocular pressure value (odds ratio [OR]= 2.01; p=0.016) and greater percentage of initial (30 days) intraocular pressure reduction (OR= 1.02; p=0.033) were sig nificantly associated with surgical success. CONCLUSIONOur findings suggest that phacoemulsification with Kahook Dual Blade goniotomy is an effective and safe alternative for cataract management in eyes with primary open-angle glaucoma that positively impacts intraocular pressure control and medication burden. Eyes with higher baseline intraocular pressure and a more pronounced initial response to the procedure appeared to present better outcomes at 6 months. Further studies are needed to evaluate the long-term efficacy and safety profile of the procedure.