Abstract
Purpose :
To compare outcomes of phacoemulsification (Phaco) combined with ab interno trabecular excision using the SIONTM device (Phaco/SION) to ab interno trabecular excision using the Kahook Dual Blade® (Phaco/KDB).
Methods :
A total of 551 visits from 93 patients were reviewed following either Phaco/SION or Phaco/KDB from 2018-2023. Two Kaplan-Meier curves (KM) assessed survival with ≤ baseline meds while maintaining (1) [GSC - Goal Success Criteria] IOP ≤ goal IOP or (2) [QSC - Qualified Success Criteria] IOP reduction ≥ 20% with 5 mmHg ≤ IOP ≤ 21 mmHg for at least two consecutive visits. IOP and medication burden reduction were compared using a paired t-test. Retrospective, comparative study from a tertiary care center.
Results :
Thirty-one patients had Phaco/SION and 62 underwent Phaco/KDB. The most common glaucoma type in both groups was primary open-angle glaucoma (32% in Phaco/SION vs. 47% in Phaco/KDB; p=0.1). Both groups had similar baseline demographics except for baseline number of medications. Mean preoperative IOP was 15.92 ± 3.53 mmHg on 1.81 medications in Phaco/SION and 15.92 ± 4.34 mmHg on 0.19 ± 0.70 medications in Phaco/KDB (p=0.99 for IOP; p<0.001 for medications). Under GSC, the success rate was higher in the Phaco/SION at POM6 (97% vs 90%; p=0.35) and POY1 (97% vs 87%; p=0.36), although the difference was not statistically significant. Under QSC, the success rate was significantly higher in the Phaco/SION at POM6 (83% vs 50%; p<0.01) and POY1 (83% vs 37%; p<0.01). Mean IOP at POM6 was 11.97 ± 3.53 mmHg on 1.18 less medications after Phaco/SION and 13.02 ± 2.71 mmHg on 0.15 less medications after Phaco/KDB (p=0.28 for IOP; p<0.001 for medications).
Conclusions :
Phaco/SION may provide greater medication reduction than Phaco/KDB as well as more favorable QSC survival rates while maintaining a similar IOP reduction.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.