Posters

Corneal endothelial cell changes after phacoemulsification combined with excisional goniotomy with the Kahook Dual Blade or iStent: a prospective fellow-eye comparison

Poster Details

First Author: S.Dorairaj USA

Co Author(s):                        

Abstract Details

Purpose:

To characterize changes in endothelial cell density and morphology following phacoemulsification combined with either excisional goniotomy (G) with the Kahook Dual Blade (CE+G with KDB) or iStent trabecular microbypass implantation (CE+iStent).

Setting:

A single clinical practice

Methods:

13 adult subjects from one center with visually significant cataract and mild-moderate open-angle glaucoma underwent CE+G with KDB in one eye and CE+iStent in the fellow eye as part of a prospective, multicenter, randomized trial. Specular microscopy and pachymetry were performed before and at least 12 months after surgery. Parameters analyzed included change from baseline of endothelial cell density (ECD), the coefficient of variation (CV), the percent of hexagonal cells (%HEX), and central corneal thickness (CCT).

Results:

Baseline ECD, CV, %HEX, and CCT were similar between groups (%HEX was marginally greater in CE+G with KDB eyes: 38.8% vs 33%; p=0.036). A mean of 14.2 ± 3.1 months postoperatively (range 12.5-23.3 mo), the change from baseline in ECD was significantly greater in the CE+iStent group (-243.2 ± 247.2 cells/mm2) than the CE+G with KDB group (-63.1 ± 256.3 cells/mm2; p=0.004631 by paired t-test), as was the percent change from baseline (-9.2% versus -2.6%, p=0.007776). No significant differences in change from baseline in CV, %HEX, or CCT were noted.

Conclusions:

CE+iStent resulted in statistically greater reduction from baseline in ECD compared to CE+G with KDB after one year of follow-up.  Longer-term data and analysis of a larger cohort of patients is currently underway.

Financial Disclosure:

None