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Abstract #126428 Published in IGR 25-2

Postoperative Use of Pilocarpine After Kahook Dual Blade Goniotomy in Mild to End-Stage Glaucoma

PURPOSE: This study aims to determine if using pilocarpine postoperatively affects clinical outcomes after goniotomy. METHODS: Retrospective series comparing 532 Kahook Dual Blade goniotomy (KDB-G) procedures with (P+) or without (P-) pilocarpine use in the postoperative period. This study includes patients with both primary and secondary glaucoma ranging from mild to end-stage, undergoing KDB-G with or without phacoemulsification (phaco). The primary outcome measure was surgical success defined as intraocular pressure (IOP) < 21 mmHg in addition to either a reduction of >20% and/or the reduction of ≥1 topical glaucoma medications. Secondary outcomes were mean IOP, number of medications, and rate of hyphema and IOP spike at one week postoperatively. RESULTS: The success rate was significantly greater in Group P + at postoperative month 1 ( = .02), 3 ( = .01), 12 ( = .048), and 16 ( = .02). The differences in mean IOP ( = .084) and number of medications ( = .15) were not significantly different at one year. However, Group P + required significantly less medications than Group P - at nearly all time points (months 1, 3, 6, 20, and 24). There were no differences in rates of hyphema ( = .30) or postoperative week 1 IOP spikes ( = .66) between groups. CONCLUSION: The use of pilocarpine postoperatively may improve surgical success and may reduce the number of glaucoma medications needed after goniotomy.

Department of Ophthalmology, University of Colorado, Aurora, CO, USA.

Classification:

15 Miscellaneous

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