Journal of current glaucoma practice · 2025
Impact of Postoperative Intraocular Pressure Spikes on Outcomes Following Goniotomy: A Comparative Study of Surgical Techniques.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Shalaby Wesam Shamseldin, Chang Steven Lee, Yu Julia, Horan Teresa, Shah Sagar, Hallaj Shahin, Moster Marlene, Razeghinejad Reza, Lee Daniel, Pro Michael, Shukla Aakriti, Huang Ping, Myers Jonathan, Xia Tina, Amarasekera Dilru
Аннотация
AIM AND BACKGROUND: To compare postoperative intraocular pressure (IOP) spikes and 1-year surgical success among goniotomy procedures: Kahook Dual Blade (KDB), OMNI, bent ab interno needle goniotomy (BANG), and gonioscopy-assisted transluminal trabeculotomy (GATT).
MATERIALS AND METHODS: This single-center, retrospective chart review included glaucoma patients ≥18 years, who underwent goniotomy from January 2021 to December 2022 with ≥3 months of follow-up. Primary outcomes were IOP spikes (≥10 mm Hg increase within 3 months) and 12-month surgical success (≥20% IOP and/or ≥1 medication reduction without further surgery). Secondary outcomes included IOP and medication changes.
RESULTS: Among 247 eyes (107 KDB, 63 OMNI, 77 BANG; all with phacoemulsification), IOP spikes occurred in 13.0% with no difference between groups (p = 0.900). Spikes were more common in severe glaucoma and associated with failure (p = 0.041), postoperative interventions (p <0.001), and reoperation (p = 0.026). At 12 months (n = 164), 68.9% achieved success with no difference between procedures (p = 0.972). Lower baseline IOP, open-angle glaucoma (OAG), and IOP spikes predicted failure. GATT eyes (n = 39, mostly standalone) had different baseline characteristics, were excluded from main analysis, but showed similar success (79.3%) with greater IOP and medication reduction.
CONCLUSION: Kahook Dual Blade, OMNI, and BANG with phacoemulsification had comparable 1-year safety and efficacy. IOP spikes increase the risk of failure and reoperation, especially in severe glaucoma. GATT showed favorable outcomes when performed standalone.
CLINICAL SIGNIFICANCE: Choice among KDB, OMNI, and BANG can be individualized without compromising outcomes. Monitoring for IOP spikes is crucial in high-risk eyes. Standalone GATT offers strong results when cataract surgery is not needed.
HOW TO CITE THIS ARTICLE: Shalaby WS, Chang SL, Yu J, et al. Impact of Postoperative Intraocular Pressure Spikes on Outcomes Following Goniotomy: A Comparative Study of Surgical Techniques. J Curr Glaucoma Pract 2025;19(4):186-198.
MATERIALS AND METHODS: This single-center, retrospective chart review included glaucoma patients ≥18 years, who underwent goniotomy from January 2021 to December 2022 with ≥3 months of follow-up. Primary outcomes were IOP spikes (≥10 mm Hg increase within 3 months) and 12-month surgical success (≥20% IOP and/or ≥1 medication reduction without further surgery). Secondary outcomes included IOP and medication changes.
RESULTS: Among 247 eyes (107 KDB, 63 OMNI, 77 BANG; all with phacoemulsification), IOP spikes occurred in 13.0% with no difference between groups (p = 0.900). Spikes were more common in severe glaucoma and associated with failure (p = 0.041), postoperative interventions (p <0.001), and reoperation (p = 0.026). At 12 months (n = 164), 68.9% achieved success with no difference between procedures (p = 0.972). Lower baseline IOP, open-angle glaucoma (OAG), and IOP spikes predicted failure. GATT eyes (n = 39, mostly standalone) had different baseline characteristics, were excluded from main analysis, but showed similar success (79.3%) with greater IOP and medication reduction.
CONCLUSION: Kahook Dual Blade, OMNI, and BANG with phacoemulsification had comparable 1-year safety and efficacy. IOP spikes increase the risk of failure and reoperation, especially in severe glaucoma. GATT showed favorable outcomes when performed standalone.
CLINICAL SIGNIFICANCE: Choice among KDB, OMNI, and BANG can be individualized without compromising outcomes. Monitoring for IOP spikes is crucial in high-risk eyes. Standalone GATT offers strong results when cataract surgery is not needed.
HOW TO CITE THIS ARTICLE: Shalaby WS, Chang SL, Yu J, et al. Impact of Postoperative Intraocular Pressure Spikes on Outcomes Following Goniotomy: A Comparative Study of Surgical Techniques. J Curr Glaucoma Pract 2025;19(4):186-198.