Abstract #80767 Published in IGR 20-3

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

Kim WJ; Kim JM; Lee WH; Kim KN; Kim CS
Clinical and Experimental Ophthalmology 2019; 47: 757-765

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.

Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Korea.

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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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