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Cataract/Anterior Segment
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Combined single-use dual blade goniotomy, cataract surgery improves outcomes

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Combined single-use dual blade goniotomy (SBG) and cataract surgery in eyes with high tension glaucoma (HTG) and normal tension glaucoma (NTG) significantly lowered intraocular pressure (IOP), according to a study.

The novel ab interno procedure may remove between 3 to 5 clock hours of trabecular meshwork (TM), according to the authors.

In this retrospective study, researchers evaluated IOP and the use of topical glaucoma medication in 55 eyes of 38 patients, 44 that had HTG and 11 that had NTG.

Complete success (no medication) and qualified success (with medication) were evaluated for IOP levels ≤21, ≤18, and ≤16 mmHg or ≥20% IOP reduction at 2- and 6-month follow-ups.

From pre-procedure to 2 months follow-up there was a significant reduction in IOP and medication use in HTG (IOP: 19.4 ± 3.3 to 15.1 ± 3.3 mmHg; P<0.001; Medication: 2.1 ± 1.3 to 0.8 ± 1.3; P<0.001) and NTG (IOP: 14.0 ± 2.3 to 11.5 ± 2.3 mmHg; P = 0.004; Medication 1.6 ± 0.7 to 0.3 ± 0.7; P<0.001) patients.

There was no significant change from 2 months after combined SBG and cataract surgery to 6 months.

In eyes with HTG, complete success rates were 43% (19/44) for IOP ≤18 mmHg, 36% (16/44) for IOP ≤16 mmHg, and 30% (13/44) for ≥20% IOP reduction 6 months after surgery; qualified success rates were 93% (41/44), 64% (28/44), and 43% (19/44), respectively.

In eyes with NTG, complete and qualified success rates were 81% (9/11) and 100% (11/11) for IOP ≤18 and ≤16 mmHg, and 27% (3/11) for IOP reduction ≥20%.

IOP and medication reduction were comparable between the groups.

Reference
Baumgarten S, Plange N, Htoon HM, et al. Outcomes of combined single-use dual blade goniotomy and cataract surgery. Int Ophthalmol. 2022;doi: 10.1007/s10792-022-02257-x. Epub ahead of print. PMID: 35357642.

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