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ORIGINAL ARTICLE
Year : 2022  |  Volume : 36  |  Issue : 2  |  Page : 195-200

Six months' follow-up of combined phacoemulsification–kahook dual blade excisional goniotomy


1 Faculty of Medicine, Saint-Joseph University; Department of Glaucoma, Beirut Eye and ENT Specialist Hospital, Byblos, Lebanon
2 Department of Glaucoma, Beirut Eye and ENT Specialist Hospital; Lebanese American University, Gilbert and Rose-Mary Chagoury School of Medicine, Byblos, Lebanon
3 Department of Glaucoma, Beirut Eye and ENT Specialist Hospital, Byblos, Lebanon
4 Faculty of Medicine, Saint-Joseph University, Byblos, Lebanon
5 Department of Ophthalmology, Mayo Clinic, Jacksonville, Florida, USA
6 Faculty of Medicine, Saint-Joseph University; Department of Glaucoma, Beirut Eye and ENT Specialist Hospital, Byblos, Lebanon; Department of Ophthalmology, Mayo Clinic, Jacksonville, Florida, USA

Correspondence Address:
Dr. Ziad Khoueir
Department of Glaucoma, Beirut Eye and ENT Specialist Hospital, Hotel Dieu Street, Mathaf Square, 116-5311, Beirut

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sjopt.sjopt_151_21

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PURPOSE: This study reports on the combination of excisional goniotomy and cataract extraction in the management of glaucoma in terms of intraocular pressure (IOP) and glaucoma medication reduction. METHODS: This is a retrospective case series. Twenty-eight eyes of 22 patients with the diagnosis of cataract and ocular hypertension or glaucoma of any stage underwent combined phacoemulsification and Kahook Dual Blade (KDB) goniotomy, between March 2019 and September 2020. The parameters evaluated were postoperative best-corrected visual acuity, mean IOP reduction, number of IOP-lowering medications, and the surgical success rate defined as IOP reduction >20% and/or reduction in glaucoma medications >1. RESULTS: The mean IOP reduction at 6 months was 4.5 mmHg (P = 0.0007), which translates to 24.9% reduction from preoperative IOP. The mean preoperative number of glaucoma medications was 2.9 ± 1.0 (median of 3). It was reduced to 1.1 ± 1.1 (median of 1.5), 1.46 ± 1.17 (median of 2), 1.44 ± 1.28 (median of 2), and 1.56 ± 1.28 (median of 2) at 1 week, 1 month, 3 months, and 6 months, respectively. Twenty-nine percent (8/28) of the patients were off glaucoma medications at 6 months and 46% (13/28) had a reduction of more than 50% of their glaucoma medications. CONCLUSION: Combined phacoemulsification–KDB excisional goniotomy may be an effective and safe alternative to more invasive filtering surgery in glaucoma patients of any stage.


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