Purchase this article with an account.
Jang Hyun Kim, Daniel Hayes, Allison Angelilli, Robert Rothman, Arnold Prywes, Craig Marcus; Comparison and efficacy of three surgical goniotomy techniques. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6647.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
There are currently no studies that directly compare the efficacy of the following three minimally invasive glaucoma surgeries indicated for the treatment of open-angle glaucoma: Trabectome, Kahook dual blade goniotomy, and VISCO360TM canaloplasty with goniotomy. We conducted a retrospective, non-randomized, observational cohort study to compare the efficacy of these three procedures.
A total of 112 patients who had received one of the three procedures combined with cataract surgery between September 2011 and January 2018 were included in the study. Efficacy was measured by changes in intraocular pressure (IOP), number of glaucoma medications, and visual acuity (VA) before and after the procedure; post-procedure follow up period was six months. A paired T test between the pre-procedure and each post-procedure time points was used to evaluate efficacy of each individual procedure. Two-way repeated measures ANCOVA was used to compare the efficacies of the procedures.
All three procedures, which consisted of Trabectome (n=50), Kahook dual blade goniotomy (n=43), and VISCO360TM canaloplasty with goniotomy (n=19), achieved statistically significant reduction in IOP and number of medications and increase in visual acuity after the procedure. There were no statistically significant differences in postoperative repeated IOP (F(2,108) = 0.393, p=0.676), number of glaucoma medications (F(2,108) = 1.096, p=0.338), and visual acuity (F(2,108) = 1.234, p=0.295) among the three procedures when pre-procedure measures were controlled.
Our results show that each of the angle procedures is effective in reducing the IOP and the number of medications used post-operatively, as well as improving the visual acuity (in concert with cataract surgery). The study, however, could not distinguish a statistical significance among the three techniques used regarding those parameters.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
Table: Pre and post procedure comparison in outcome measures by procedure Note: Numbers reported for number of glaucoma medications and visual acuity reflect post-data transformation using the square root function to normalize the data
This PDF is available to Subscribers Only