Abstract
Purpose :
Minimally Invasive Glaucoma Surgeries (MIGS) are frequently performed standalone or combined with phacoemulsification to reduce intraocular pressure (IOP) and decrease the need for antiglaucoma medications (AGMs). However, there is limited data on MIGS outcomes when performed in combination with one another. This study aims to evaluate the safety and efficacy of combined goniotomy and canaloplasty performed in conjunction with cataract surgery, up to 12 months post-operatively.
Methods :
Retrospective review of forty-two glaucomatous eyes receiving phacoemulsification followed by goniotomy and canaloplasty. Primary outcomes included change in both IOP and number of AGMs compared to baseline, up to 12 months post-operatively. Secondary outcomes included the percentage of eyes achieving an IOP <17 mmHg and/or 20% IOP reduction compared to baseline, at 12 months post-operatively.
Results :
Forty-two eyes of 31 patients were analyzed. The majority of eyes were female (n=25, 59.5%) and Caucasian (n=31, 73.8%). Mean age (standard deviation) was 67 (12.7) years. Baseline medicated mean IOP was 18.1 ± 7.3 mmHg and mean number of AGMs was 1.7 ± 1.5. Post-operatively, reduction in IOP at 1, 3, 6, 9, and 12 months was -3.1 (n=43, p=0.02), -4.6 (n=28; p=0.002), -2.75 (n=16; p=0.09), -3.2 (n=14; p=0.14), and -4.4 (n=10, p=0.04). Reduction in AGMs at 1, 3, 6, 9, and 12 months was respectively -0.8 (n=43, p<0.001), -0.9 (n=28; p<0.001), -0.9 (n=16; p<0.01), -0.8 (n=14; p<0.01), and -0.8 (n=10; p=0.02). At 12 months, IOP and number of AGMs were reduced by 24.3% and 34.8% (both p<0.05), respectively. 90% of eyes achieved IOP < 17 mmHg and 50% of eyes had at least a 20% IOP reduction from baseline at 12 months. The most frequent postoperative complications were mild hyphema (n=6) and transient hypotony (n=5). Only one eye required a secondary glaucoma surgery before 12 months due to glaucoma progression. No vision-threatening complications were reported.
Conclusions :
Goniotomy with canaloplasty following phacoemulsification was successful at reducing both IOP and AGMs, up to 12 months post-operatively. No serious adverse events were reported.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.