Abstract
Purpose :
Kahook Dual Blade (KDB) goniotomy has proven effective in lowering intraocular pressure (IOP) and reducing the medication burden in patients with glaucoma. This study compares outcomes of a KDB goniotomy combined with phacoemulsification (phaco-KDB) between an ophthalmology attending and resident surgeons.
Methods :
A retrospective analysis was performed on 96 eyes of 72 patients who received a phaco-KDB performed by either an ophthalmology attending or a senior ophthalmology resident under direct guidance of the attending. Data for each patient was collected preoperatively and at 1 week, 1 month, 3 months, 6 months, and 12 months postoperatively. The primary outcome measure was surgical success, defined as 20% IOP reduction or at least 1 medication reduction at each measured time point and incidence of any complications.
Results :
Comparison of patient’s demographic information and glaucoma subtype/severity were not statistically significant between the resident’s and attending’s respective cohorts. Patient’s pre-operative mean IOP (p=0.938) and baseline glaucoma medications (p=0.164) were also comparable among the resident’s and attending’s study populations. At 6 months (63.5% in attending cohort vs. 87.5% in resident’s cohort) and 12 months (55.8% vs. 84.6%), primary surgeon was not significantly associated with outcome (P>0.05). Percent IOP reduction (5.8% vs. 18.1%) and medication reduction (1.2 vs. 0.7) did not differ between the groups at 6 or 12 months (P>0.05). Which surgeon performed the procedure did not significantly predict surgical complications (P=0.05). The survival distributions between the attending (mean 710.184±34.1 days) and resident (mean 724.5±29.8 days) were also not significantly different (χ2=2.013, P=.156).
Conclusions :
Primary surgeon was not associated with outcome of phaco-KDB at any of the evaluated post-operative time points. The attending and residents had similar % IOP and medication reductions, complication rates, and survival distributions. This suggests phaco-KDB is an effective procedure with relatively short learning curve and can be safely performed by a trainee under direct supervision of experienced surgeon.
This is a 2020 ARVO Annual Meeting abstract.