Relationship between selective laser trabeculoplasty and excisional goniotomy outcomes in glaucomatous eyes

Abstract

ObjectiveTo evaluate the relationship between intraocular pressure (IOP)-lowering success with selective laser trabeculoplasty (SLT) and Kahook Dual Blade (KDB) goniotomy in eyes with glaucoma. DesignRetrospective chart review. Participants30 eyes of 24 patients undergoing phacoemulsification combined with a KDB with 6 months follow-up and who had previously undergone SLT in the same eye. MethodsData collected from electronic health records included demographic and glaucoma status, IOP and IOP-lowering medication after SLT and KDB. SLT and KDB success were defined as IOP reduction ≥20% or medication reduction ≥1 at 2 and 6 months, respectively. Main outcomeAssociation between SLT success and KDB success. ResultsOverall, SLT was successful in 17 of 30 eyes (56.7%) at 2 months, and KDB was successful in 18 of 30 eyes (60%) at 6 months. Nine of 17 eyes (52.9%) with prior successful SLT had successful subsequent KDB, whereas 9 of 13 (69.2%) with prior unsuccessful SLT had successful KDB. There was no significant relationship between SLT and KDB outcome in these 30 eyes (p = 0.465 by Fisher's exact test). ConclusionNo relationship between success of SLT and subsequent KDB was observed. However, patients with history of failed SLT still benefited from subsequent KDB.