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Long-term follow-up of combined phacoemulsification and excisional goniotomy with the kahook dual blade in patients with cataract and glaucoma in Saudi Arabia

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First Author: A.Al Habash SAUDI ARABIA

Co Author(s):    A. Al Bainain                    

Abstract Details

Purpose:

To characterize the changes in intraocular pressure (IOP), IOP-lowering medications, and visual acuity (VA) through up to 3 years of follow-up in patients undergoing combined phacoemulsification and excisional goniotomy with the Kahook Dual Blade (phaco-KDB) by a single surgeon in Saudi Arabia.

Setting:

King Fahd Hospital of the University, Khobar, Saudi Arabia.

Methods:

The health records of 55 eyes of 47 patients undergoing phaco-KDB by a single surgeon were reviewed. Data were extracted from visits occurring preoperatively (n=55), intraoperatively (n=55), and 1 day (n=55), 2 weeks (n=55), 4-6 weeks (n=49), 2-3 months (n=55), and 6 (n=55), 9 (n=55), 12 (n=55), 18 (n=49), 24 (n=46), and 36 months (n=16) postoperatively. Data collection included IOP, IOP-lowering medications, and VA at each time point. Adverse events were also collected. Paired t-tests were used to compare IOP, medications, and VA at each time point to preoperative values.

Results:

Mean (standard error) baseline IOP was 20.4 (0.7) mmHg and through up to 36 months of follow-up ranged from 13.6 to 14.1 mmHg; significant reductions (p<0.001) of 5.7-6.8 mmHg (28.8-33.8%) were achieved at every time point. Medications were reduced from 3.2 (0.1) to 0.2-2.0 (minus 1.2-3.0 medications [37.6-94.8%]; p<0.001 at every time point). At Months 24 and 36, mean IOP was 13.9 (0.3) and 13.9 (0.5) mmHg (p<0.001); mean medications were 1.4 (0.2) and 2.0 (0.4) (p<0.001). Mean logMAR VA improved from 1.0 (0.1) preoperatively to (0.2 [0.0]; p<0.001) by Month 6, remaining stable thereafter.

Conclusions:

Phaco-KDB significantly lowered IOP approximately 30% by Day 1 with consistency and durability through 3 years. Medication use was reduced by >50% at 24 months and 38% at 36 months. Mean logMAR VA improved from 1.0 to 0.2 (Snellen equivalent 20/200 to 20/32). This procedure provides meaningful visual rehabilitation with long-term reductions in IOP and the need for IOP-lowering medications in Saudi Arabian eyes with cataract and glaucoma.

Financial Disclosure:

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