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36-Month Outcomes of Standalone Kahook Dual Blade Goniotomy Compared with Ab-Interno Closed Conjunctiva Xen Gel Stent Implantation.
Boopathiraj, Nithya; Wagner, Isabella V; Lentz, Paul Connor; Draper, Christian; Krambeer, Chelsey; Abubaker, Yazan S; Ang, Bryan Chin Hou; Miller, Darby D; Dorairaj, Syril.
Afiliación
  • Boopathiraj N; Department of Ophthalmology, Mayo Clinic, Jacksonville, FL, USA.
  • Wagner IV; Department of Ophthalmology, Mayo Clinic, Jacksonville, FL, USA.
  • Lentz PC; Department of Ophthalmology, Mayo Clinic Alix School of Medicine, Jacksonville, FL, USA.
  • Draper C; Department of Ophthalmology, Eye Consultants, Spokane, WA, USA.
  • Krambeer C; Department of Ophthalmology, Mayo Clinic, Jacksonville, FL, USA.
  • Abubaker YS; Department of Ophthalmology, Mayo Clinic, Jacksonville, FL, USA.
  • Ang BCH; Department of Ophthalmology, Mayo Clinic, Jacksonville, FL, USA.
  • Miller DD; Department of Ophthalmology, Tan Tock Seng Hospital, National Healthcare Group Eye Institute, Singapore.
  • Dorairaj S; Department of Ophthalmology, Woodlands Health, National Healthcare Group Eye Institute, Singapore.
Clin Ophthalmol ; 18: 2593-2603, 2024.
Article en En | MEDLINE | ID: mdl-39309685
ABSTRACT

Purpose:

To compare the safety and effectiveness of standalone Kahook Dual Blade (KDB) excisional goniotomy to standalone ab-interno Xen gel stent implantation in eyes with moderate-to-severe open-angle glaucoma (OAG).

Methods:

A single-center, retrospective study including eyes with moderate-to-severe OAG undergoing standalone KDB goniotomy or Xen gel stent implantation was conducted. Intraocular pressure (IOP), the number of antiglaucoma medications taken daily, and best-corrected visual acuity (BCVA) were recorded at baseline and for up to 36-months. Primary outcomes assessed included changes from baseline in IOP and the number of antiglaucoma medications taken. Intergroup comparisons were conducted using independent-samples Student's t-tests. The incidence of intraoperative and postoperative adverse events and the need for glaucoma surgical re-interventions were also recorded.

Results:

Eyes receiving standalone KDB (n=26) or Xen gel stent (n=45) surgery were analyzed. The baseline mean IOP and number of antiglaucoma medications in both groups were as follows KDB 23.2 ± 6.0 mmHg, 2.2 ± 1.4 medications; Xen 22.7 ± 8.8 mmHg, 3.0 ± 1.0 medications. At 36 months, IOP was reduced to 16.6 ± 5.4 mmHg in KDB eyes (n=23, -23.5%; p=0.0004) and 15.3 ± 5.6 mmHg in Xen gel stent eyes (n=15, -22.1%; p=0.006), while number of antiglaucoma medications was reduced to 1.1 ± 0.7 (-30.8%; p=0.0005) and 2.2 ± 1.4 (-25.6%; p=0.01), respectively. Three eyes (11.5%) in the KDB group and 19 eyes (42.2%) in the Xen gel stent group required additional surgery before month 36 due to refractory high IOP.

Conclusion:

Both KDB goniotomy and Xen gel stent implantation significantly lowered the IOP and antiglaucoma medication burden in patients with moderate-to-severe OAG. While the Xen gel stent is frequently used to treat moderate-to-severe OAG patients with uncontrolled IOP, standalone KDB goniotomy may be equally effective as a long-term intervention, reducing the need for subsequent glaucoma surgery.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Clin Ophthalmol Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Nueva Zelanda
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Clin Ophthalmol Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Nueva Zelanda