June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Investigating the Risk Factors for Failure of a Minimally Invasive Goniotomy Glaucoma Surgical Device Using a Big Data Approach
Author Affiliations & Notes
  • Krishna Prahalad Shanmugam
    Texas A&M University Health Sciences Center, Bryan, Texas, United States
  • Murugesan Raju
    MU Informatics Institute, University of Missouri System, Columbia, Missouri, United States
  • Devesh Kumar
    Medical College of Wisconsin, Milwaukee, Wisconsin, United States
  • Stephen Kwong
    Texas A&M University Health Sciences Center, Bryan, Texas, United States
  • Jacob Vargas
    Texas A&M University Health Sciences Center, Bryan, Texas, United States
  • Lema Noubani
    Texas A&M University Health Sciences Center, Bryan, Texas, United States
  • Jawad Muayad
    Texas A&M University Health Sciences Center, Bryan, Texas, United States
  • Jonathan Thomas
    Texas A&M University Health Sciences Center, Bryan, Texas, United States
  • Footnotes
    Commercial Relationships   Krishna Shanmugam None; Murugesan Raju None; Devesh Kumar None; Stephen Kwong None; Jacob Vargas None; Lema Noubani None; Jawad Muayad None; Jonathan Thomas None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 393. doi:
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      Krishna Prahalad Shanmugam, Murugesan Raju, Devesh Kumar, Stephen Kwong, Jacob Vargas, Lema Noubani, Jawad Muayad, Jonathan Thomas; Investigating the Risk Factors for Failure of a Minimally Invasive Goniotomy Glaucoma Surgical Device Using a Big Data Approach. Invest. Ophthalmol. Vis. Sci. 2023;64(8):393.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Glaucoma is the second leading cause of permanent blindness across the world due to advanced optic nerve damage and the resultant irreversible visual field defects. There have been many innovations in glaucoma treatments in the last decade, none more important than the advent of multiple subtypes of Minimally Invasive Glaucoma Surgery (MIGS). Angle-based goniotomy procedures are generally considered safe and efficacious MIGS interventions for treating glaucoma, often at the time of cataract surgery. However, postoperative surgery failures can be challenging and lead to the necessity for further glaucoma surgeries. In the present study, we analyzed demographic and health status characteristics of a large subset of patients, with a specific emphasis on patients undergoing angle-based goniotomy procedures with a Kahook Dual Blade®, to gain a deeper understanding of factors associated with MIGS failure.

Methods : We queried a large-scale electronic health record database (Health Facts ®) for the study cohort using CPT and ICD codes. Failure was defined as a need for another glaucoma procedure. Then, we classified two distinct groups: patients who have underwent MIGS-related goniotomy failures, and those who did not. We retrieved a total of 439 patients’ records along with their related comorbidities and demographic data. We applied a multivariate regression analysis to predict the correlation of goniotomy failure and comorbidities/risk factors associated with this failure.

Results : A diverse set of demographic variables including age, race, smoking status, presence of Type 2 Diabetes, and the presence of a variety of other health conditions were analyzed. Of note, in the goniotomy surgery failure group, according to odds ratio analysis, female gender and essential hypertension were two different patient characteristics associated with goniotomy failure.

Conclusions : The present study showed that several factors could possibly be predictive of angle-based goniotomy surgery failure, notably female gender and hypertension. Further understanding of these risk factors can help surgeons better manage glaucoma care and tailor each type of MIGS device to the specific demographic and systemic health status of their patients. This study demonstrates the potential use of large-scaled EHR data to analyze risk factors for MIGS related angle-based goniotomy surgery failure.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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