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. 2022 Jun;70(6):2030-2035.
doi: 10.4103/ijo.IJO_2969_21.

Six-month outcomes of combined conventional needle goniotomy and phacoemulsification in eyes with early to moderate primary open-angle and pseudoexfoliation glaucoma and ocular hypertension

Yadollah Eslami  1 , Massood Mohammadi  1 , Mona Safizadeh  1 , Seyed Mehdi Tabatabaei  1
Affiliations

Six-month outcomes of combined conventional needle goniotomy and phacoemulsification in eyes with early to moderate primary open-angle and pseudoexfoliation glaucoma and ocular hypertension

Yadollah Eslami et al. Indian J Ophthalmol. 2022 Jun.

Abstract

Purpose: Angle-based surgeries for the treatment of open-angle glaucoma have gained popularity in recent years. This study aimed to evaluate the efficacy of combined phacoemulsification and goniotomy in primary open-angle and pseudoexfoliation glaucoma (POAG and PXG) and ocular hypertension (OHTN).

Methods: In this interventional case series in the setting of the Glaucoma Service at the Farabi Eye Hospital, 32 eyes of 30 patients with early-to-moderate POAG and PXG and OHTN were enrolled. All eyes underwent combined phacoemulsification and needle goniotomy. Intraocular pressure (IOP) and the number of antiglaucoma medications as well as demographic data were recorded at baseline and one day, one week, one month, three months, and six months after the surgery. Generalized Estimating Equation (GEE) was used to compare the values of IOP and the number of medications at different time points. Kaplan-Meier graph was used to demonstrate the survival status of the eyes.

Results: Mean IOP at baseline was 21.8 ± 4.6 mmHg on mean 1.2 ± 1.5 topical medications. There was a 25.2% (16.3 ± 4.5 mmHg) and 32.1% (14.8 ± 3.9 mmHg) reduction in IOP at three and six months after procedure, respectively (P < 0.001). Meanwhile, the decline in medications was 66.7% (0.4 ± 0.9) and 50.0% (0.6 ± 1.1) at the same time points (P = 0.002 and P = 0.048, respectively). Post-operative complications were clot hyphema (n = 1, 3.1%), fibrinous inflammation (n = 1, 3.1%) and distorted pupil (n = 2, 6.3%).

Conclusion: Combined phacoemulsification and needle goniotomy as a procedure for mild and moderate POAG and PXG and OHTN is as effective as other modified goniotomies in the setting of minimally invasive glaucoma surgeries (MIGS).

Keywords: Early to moderate glaucoma; goniotomy; ocular hypertension; primary open-angle glaucoma; pseudoexfoliation glaucoma.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
Change of intraocular pressure at different time points during the study
Figure 2
Figure 2
Change of the number of antiglaucoma medications at different time points during the study
Figure 3
Figure 3
Kaplan–Meier survival curve for the study eyes
Figure 4
Figure 4
(a) Nasal quadrant of angle. Note the exposed canal with different light reflex. (b) The temporal quadrant of the angle has a normal appearance
See this image and copyright information in PMC

Comment in

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