Abstract
Purpose :
To compare refractive outcomes and visual acuity (VA) in eyes undergoing cataract extraction (CE) alone, CE with goniotomy/viscocanalostomy (CE/GV), and CE with Schlemm’s canal stent (CE/SCS) insertion.
Methods :
Eyes from the Bascom Palmer Glaucoma Repository undergoing CE/GV (Current Procedural Terminology (CPT) codes 66984 and 66174 or 65820) or CE/SCS (CPT 66984 with 0191T or 66991) insertion between July 2014 and February 2022 were identified. Controls were glaucoma patients undergoing uncomplicated CE alone (CPT 66984). Refraction data were analyzed at post-operative month 1 (POM1) and post-operative month 12 (POM12) with Kruskal-Wallis and Dunn’s tests. Anisometropia was defined as a spherical equivalent (SE) diopteric difference of ≥2 between eyes of patients undergoing different procedures.
Results :
A total of 11,212 eyes from 8,334 patients were analyzed (219 CE/GV, 534 CE/SCS, and 10,459 CE alone). Mean age was 70.4 years, with 57% female, 19% Black, and 39.2% Hispanic/Latino patients. At POM1, mean spherical equivalent (SE) values were -0.35±0.90D (CE/GV), -0.32±0.83D (CE/SCS), and -0.39±0.90D (CE alone; p=0.043, CE/SCS vs. CE alone). Mean sphere values were -0.64±0.94D (CE/GV), -0.62±0.88D (CE/SCS), and -0.70±1.00D (CE alone; p=0.047, CE/SCS vs. CE alone). Mean cylinder values were 0.68±0.64D (CE/GV), 0.67±0.58D (CE/SCS), and 0.72±0.75D (CE alone; p>0.900). Mean logMAR VA was 0.11±0.20 (CE/GV), 0.09±0.19 (CE/SCS), and 0.13±0.26 (CE alone; p=0.009, CE/SCS vs. CE alone). At POM12, SE values were -0.41±0.87 (CE/GV), -0.15±0.86 (CE.SCS), and -0.38±1.08 (CE alone; p=0.060). Sphere values were -0.59±0.84D (CE/GV), -0.64±0.81D (CE/SCS), and -0.77±1.13D (CE alone; p=0.288). Cylinder values were 0.55±0.35D (CE/GV), 0.93±0.60D (CE/SCS), and 0.86±0.82D (CE alone; p=0.054). Anisometropia occurred at POM1 in 2 patients (5.6%) in CE/SCS-CE group, 2 patients (12.5%) in CE/GV-CE group, and 214 patients (4.9%) in CE-CE group (p=0.223). Mean SE difference between both eyes was -0.12±0.68D, -0.41±1.09D, and 0.00±0.99D respectively (p=0.166).
Conclusions :
This study compared refractive outcomes between CE/GV and CE/SCS insertion in a large surgically treated population at an academic eye hospital. These data confirm that concurrent GV or SCS with CE does not cause clinically meaningful differences in postoperative refraction or anisometropia.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.