Abstract
Purpose :
Contralateral benefit has been associated with several topical and surgical glaucoma treatment modalities, but the longitudinal effects of goniotomy on the contralateral eye is not well-studied. This study describes outcomes in the contralateral eye up to 5 years after goniotomy.
Methods :
A single-center retrospective study of patients undergoing goniotomy from January 2012-May 2022 was conducted. Patients who underwent Kahook Dual Blade or TrabEx surgeries with and without cataract extraction were included. Patients receiving surgery in the contralateral eye within 6 months before or after the index goniotomy, without a diagnosis of glaucoma or ocular hypertension in the contralateral eye, and without adequate follow-up were excluded. Follow-up data was collected until a glaucoma surgery to the contralateral eye was performed, if applicable. Primary outcomes were IOP and number of topical pressure-lowering agents in the contralateral eye at pre-operative baseline and 1 month, 3 months, 6 months, 1 year, 2 years, 3 years, 4 years, and 5 years after surgery to the index eye. Patient characteristics were delineated with descriptive statistics. Paired t-tests were used to determine significance between timepoints.
Results :
A total of 277 patients were included. Average patient age was 75.2 ± 12.4 years; 56.3% of patients were female, and 53.1% of patients identified as White. IOP at baseline, 1 month, 3 months, 6 months, 1 year, 2 years, 3 years, 4 years, and 5 years was 16.1 ± 5.5 mmHg (n=277), 15.6 ± 5.7 mmHg (n=261, p = 0.0392), 15.2 ± 5.9 mmHg (n=192, p = 0.0037), 14.5 ± 5.4 mmHg (n=214, p = 0.0024), 14.4 ± 4.9 mmHg (n=229, p<0.001), 14.0 ± 5.0 mmHg (n=187, p<0.001), 13.2 ± 4.6 mmHg (n=122, p<0.001), 13.3 ± 4.7 mmHg (n=85, p<0.001), and 13.1 ± 3.8 mmHg (n=38, p = 0.0029), respectively. Mean number of topical pressure-lowering agents at baseline was 2.1 ± 1.6 agents, compared to 2.2 ± 1.3 agents at 5 years (p = 0.653). 5.42% of patients were on oral pressure-lowering medications at baseline, decreased to 2.63% at 5 years.
Conclusions :
This study suggests that goniotomy results in significantly decreased IOP in a contralateral eye affected by glaucoma or ocular hypertension up to 5 years after index surgery. Medication burden in the contralateral eye remained similar.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.