Twelve-month outcomes of Kahook dual blade goniotomy combined with cataract surgery in Latino patients.

Abstract

To evaluate 12month surgical outcome of Kahook Dual Blade (KDB) goniotomy in combination with cataract surgery in Latino patients with open angle glaucoma (OAG) and ocular hypertension (OHT). This retrospective study included 45 eyes of 40 patients who underwent KDB goniotomy combined with cataract extraction from January 2016 to September 2020 at two centers in South America. Primary outcome was surgical success defined as ≥ 20% intraocular pressure (IOP) reduction or ≥ 1 medication reduction from preoperative without additional IOP-lowering procedures and an IOP ≥ 5mmHg or ≤ 21mmHg. Additionally, we used 2 cutoffs values for success of IOP ≤ 18 and ≤ 15mmHg. Secondary outcomes included: IOP, medication use, best corrected visual acuity, complications and failure-associated factors. Success rates at 12months with cutoff limits of 21, 18 and 15mmHg were 84.3%, 75.6% and 58.7%, respectively. At 12months, mean preoperative IOP significantly decreased from 19.23 ± 0.65mmHg on 2.3 ± 1.0 medications to 14.33 ± 0.66mmHg on 0.6 ± 0.9 medications(p<0.001) , with 62% of eyes free of hypotensive medication. Eyes that developed postoperative IOP spikes showed a higher risk for failure using the cutoff limit of IOP ≤ 18mmHg with a hazard ratio of 3.6 (95% confidence interval [CI], 1.80-7.13; p < 0.001). There were no serious ocular adverse events. KDB combined with cataract extraction showed safety and efficacy for decreasing IOP in OAG and OHT Latino patients. Additionally, dependence on medications was reduced significantly after surgery.