Efficacy and Safety of Kahook Dual Blade Goniotomy: 18-Month Results.
Efficacy and Safety of Kahook Dual Blade Goniotomy: 18-Month Results.
复制标题
Kahook 双刀片前房角切开术的功效和安全性：18 个月的结果。
DOI：
10.1097/j.jcrs.0000000000000263
复制
发表时间：
2020
影响因子：
2.8
通讯作者：
Henry C Tseng
中科院分区：
文献类型：
--
作者：
Susan M. Wakil;F. Birnbaum;Daniel M. Vu;Shan McBurney;M. Elmallah;Henry C Tseng
目的
比较Kahook双刃前房角切开术（KDB）联合白内障手术（超声乳化KDB）或作为独立手术（KDB）的18个月有效性和安全性。
设置
一个外科医生的实践。
设计
回顾性研究。
方法
2016年5月至2018年，由一名经验丰富的外科医生对100例患者的116只眼进行了KDB。超声乳化KDB组和KDB组分别有93只眼和23只眼。主要结果指标为IOP降低和降IOP药物以及不良事件。收集数据并使用R.
结果
与KDB组83%的患眼相比，超声乳化KDB组71%的患眼患有中度或重度青光眼。基线时，超声乳化KDB组和KDB组的平均IOP分别为16.5± 5.0 mm Hg（n=93）和24.3±9.1（n=23）（p<0.05）。两组在12个月（14.1±3.9 vs 16.9±7.6，p=0.24）和18个月（14.4±3.7 vs 16.7±7.6，p=0.5）时IOP均降低。超声乳化KDB组和KDB组在基线（2.4±1.2 vs 2.9±1.0，p<0.05）、12个月（1.3±1.2 vs 2.6±1.2，p<0.05）和18个月（1.3 ±1.2 vs 3.3±1.2，p<0.05）时的跌落次数存在统计学显著差异。并发症包括一过性前房积血（n= 20，17%）和眼压峰（n= 20，17%）。7只眼睛需要额外的青光眼手术，其中5只在独立组中。
结论
KDB是一种有效和安全的手术，适用于不同严重程度的青光眼，无论是与白内障手术联合使用还是单独手术。KDB是在进行更具侵入性的青光眼手术之前考虑的替代方案。
PURPOSE
To compare the 18-month efficacy and safety of the Kahook Dual Blade goniotomy (KDB) in combination with cataract surgery (phaco-KDB) or as a standalone procedure (KDB).
SETTING
Single surgeon practice.
DESIGN
Retrospective review study.
METHODS
One hundred sixteen eyes of 100 patients underwent KDB by a single well-experienced surgeon from May 2016-2018. A total of 93 and 23 eyes were in the phaco-KDB and KDB groups, respectively. Main outcome measures were reduction in IOP and IOP-lowering medication as well as adverse events. Data were collected and analyzed using Welch's t-tests in R.
RESULTS
71% of eyes within the phaco-KDB group compared to 83% within the KDB group had moderate or severe glaucoma. At baseline, mean IOP was 16.5±5.0mm Hg (n=93) and 24.3±9.1 (n=23) in the phaco-KDB and KDB groups, respectively (p<0.05). The IOP decreased in both groups at 12 months (14.1±3.9 vs 16.9±7.6, p=0.24) and 18 months (14.4±3.7 vs 16.7±7.6, p=0.5). There was a statistically significant difference in the number of drops between the phaco-KDB and KDB groups at baseline (2.4±1.2 vs 2.9±1.0, p<0.05) persisting at 12 months (1.3±1.2 vs 2.6±1.2, p<0.05) and at 18 months (1.3±1.2 vs 3.3±1.2, p<0.05). Complications included transient hyphemas (n=20,17%) and IOP spike (n=20,17%). Seven eyes required additional glaucoma surgery, 5 of which were in the standalone group.
CONCLUSIONS
KDB is an effective and safe procedure for different glaucoma disease severity, whether combined with cataract surgery or as a standalone surgery. KDB is an alternative to consider prior to pursuing more invasive glaucoma surgeries.