Relationship between selective laser trabeculoplasty and excisional goniotomy outcomes in glaucomatous eyes

Can J Ophthalmol. 2022 Apr;57(2):112-117. doi: 10.1016/j.jcjo.2021.02.040. Epub 2021 Apr 8.

Abstract

Objective: To evaluate the relationship between intraocular pressure (IOP)-lowering success with selective laser trabeculoplasty (SLT) and Kahook Dual Blade (KDB) goniotomy in eyes with glaucoma.

Design: Retrospective chart review.

Participants: 30 eyes of 24 patients undergoing phacoemulsification combined with a KDB with 6 months follow-up and who had previously undergone SLT in the same eye.

Methods: Data collected from electronic health records included demographic and glaucoma status, IOP and IOP-lowering medication after SLT and KDB. SLT and KDB success were defined as IOP reduction ≥20% or medication reduction ≥1 at 2 and 6 months, respectively.

Main outcome: Association between SLT success and KDB success.

Results: Overall, SLT was successful in 17 of 30 eyes (56.7%) at 2 months, and KDB was successful in 18 of 30 eyes (60%) at 6 months. Nine of 17 eyes (52.9%) with prior successful SLT had successful subsequent KDB, whereas 9 of 13 (69.2%) with prior unsuccessful SLT had successful KDB. There was no significant relationship between SLT and KDB outcome in these 30 eyes (p = 0.465 by Fisher's exact test).

Conclusion: No relationship between success of SLT and subsequent KDB was observed. However, patients with history of failed SLT still benefited from subsequent KDB.

MeSH terms

  • Glaucoma* / surgery
  • Humans
  • Intraocular Pressure
  • Laser Therapy*
  • Lasers
  • Retrospective Studies
  • Trabecular Meshwork / surgery
  • Trabeculectomy*
  • Treatment Outcome