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Outcomes of iStent inject versus kahook dual blade surgery in glaucoma patients undergoing cataract surgery
Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Oftalmiatrik.ORCID-id: 0000-0001-6025-2523
Division of Ophthalmology and Vision, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Ophthalmology, Capio Sophiahemmet Hospital, Stockholm, Sweden.
Umeå universitet, Medicinska fakulteten, Wallenberg centrum för molekylär medicin vid Umeå universitet (WCMM). Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Oftalmiatrik. Department of Ophthalmology, University of Iceland, Reykjavik, Iceland.ORCID-id: 0000-0003-0218-4563
2023 (engelsk)Inngår i: Journal of glaucoma, ISSN 1057-0829, E-ISSN 1536-481X, Vol. 32, nr 10, s. e121-e128Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Précis: iStent Inject implantation (iStent) or Kahook Dual Blade goniotomy (KDB) in combination with phacoemulsification have a similar IOP-lowering effect in all stages of glaucoma, and medications are significantly reduced, especially after KDB.

PURPOSE: To compare the 2-year efficacy and safety of iStent or KDB in combination with phacoemulsification in eyes with mild to advanced open angle glaucoma.

METHODS: A retrospective chart review of 153 patients that received iStent or KDB in combination with phacoemulsification at a single center between March 2019 and August 2020. The main outcome parameters at 2 years were: (1) intraocular pressure (IOP)-reduction ≥20%, with a postoperative IOP ≤18 mm Hg, and (2) a reduction of ≥1 medication. Results were stratified by glaucoma grade.

RESULTS: After 2 years, mean IOP was reduced from 20.3±6.1 to 14.2±4.1 mm Hg in the phaco-iStent group ( P <0.001) and from 20.1±6.1 to 14.7±3.6 mm Hg in the phaco-KDB group ( P <0.001). The mean number of medications was reduced from 3.0±0.9 to 2.6±1.1 in the Phaco-iStent group ( P =0.001) and from 2.3±1.0 to 1.5±1.3 in the Phaco-KDB group ( P <0.001). Success regarding IOP-reduction ≥20% with a postoperative IOP ≤18 mm Hg was met by 46% in the phaco-iStent group and by 51% in the phaco-KDB group. A reduction of ≥1 medication was met by 32% in the phaco-iStent group and by 53% in the phaco-KDB group ( P =0.013). Eyes with mild to moderate and advanced glaucoma responded equally well to the success criteria.

CONCLUSIONS: iStent and KDB, in combination with phacoemulsification, both lowered IOP effectively in all stages of glaucoma. More medications were reduced after KDB, suggesting that it may be a more effective procedure compared with iStent.

sted, utgiver, år, opplag, sider
Wolters Kluwer, 2023. Vol. 32, nr 10, s. e121-e128
HSV kategori
Identifikatorer
URN: urn:nbn:se:umu:diva-215079DOI: 10.1097/IJG.0000000000002243PubMedID: 37327470Scopus ID: 2-s2.0-85172940680OAI: oai:DiVA.org:umu-215079DiVA, id: diva2:1804670
Forskningsfinansiär
Region Jämtland HärjedalenRegion VästerbottenKnut and Alice Wallenberg FoundationTilgjengelig fra: 2023-10-13 Laget: 2023-10-13 Sist oppdatert: 2024-01-15bibliografisk kontrollert

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Barkander, AnnaJóhannesson, Gauti

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