Effect of combined goniotomy and phacoemulsification on intraocular pressure in open-angle glaucoma patients.

Abstract

IMPORTANCE:

Although goniotomy is known to be successful in treating congenital glaucoma, its effect in adult glaucoma patients remains unclear.

BACKGROUND:

To evaluate the efficacy and safety of goniotomy performed simultaneously with cataract surgery in treatment of open-angle glaucoma (OAG).

DESIGN:

Retrospective comparative study.

PARTICIPANTS:

A total of 76 patients with moderately controlled OAG (intraocular pressure [IOP] ≤ 21 mmHg using medications) undergoing cataract surgery.

METHODS:

Comparison of patients who underwent the conventional goniotomy during cataract surgery (combined goniotomy group) with those who underwent cataract surgery alone (phaco group).

MAIN OUTCOME MEASURES:

Changes in IOP and medications, and complications through 12 months.

RESULTS:

Baseline IOP was 18.2 ± 2.4 mmHg in the combined goniotomy group and 17.4 ± 1.9 mmHg in the phaco group; number of medications was 2.6 ± 1.1 and 2.4 ± 0.9, respectively (P > 0.05). The reduction in IOP and medication use from baseline in the combined goniotomy group was significantly greater at 12 months compared to the phaco group (-3.1 ± 2.9 mmHg vs -1.3 ± 2.4 mmHg and -1.2 ± 0.9 vs -0.7 ± 0.9, respectively, both P < 0.05). The success rate was 76.7% in the combined goniotomy group and 50.0% in the phaco group at 12 months (P = 0.021). No significant complication was observed in either group.

CONCLUSIONS AND RELEVANCE:

Combined goniotomy and cataract surgery showed a significantly greater reduction in IOP and number of medications compared to cataract surgery alone at 1 year after surgery, with similarly favourable safety profiles.

• Authors: Woo-Jin Kim, Ju-Mi Kim, Woo-Hyuk Lee, Kyoung Nam Kim, Chang-Sik Kim
• Journal: Clinical & experimental ophthalmology (Clin Exp Ophthalmol) Vol. 47 Issue 6 Pg. 757-765 (08 2019) ISSN: 1442-9071 [Electronic] Australia
• PMID: 30924282 (Publication Type: Comparative Study, Journal Article)
• Copyright: © 2019 Royal Australian and New Zealand College of Ophthalmologists.

Chemical References

• Antihypertensive Agents

Topics

• Aged
• Antihypertensive Agents (administration & dosage)
• Female
• Glaucoma, Open-Angle (physiopathology, surgery)
• Gonioscopy
• Humans
• Intraocular Pressure (drug effects, physiology)
• Male
• Middle Aged
• Phacoemulsification
• Retrospective Studies
• Slit Lamp Microscopy
• Tonometry, Ocular
• Trabeculectomy
• Treatment Outcome
• Visual Acuity (physiology)
• Visual Fields (physiology)