Affordable Sinskey Hook Goniotomy and Cataract Surgery in Black and Afro-Latino Patients Diagnosed with Glaucoma: Retrospective Real-World One-Year Results.

Background/

Objectives

This study aimed to evaluate the effectiveness of early phacoemulsification cataract surgery combined with goniotomy using a Sinskey hook in patients with glaucoma.

Methods

This was a retrospective study conducted at Advanced Eye Care of New York; a private practice located in New York City. Most patients carried diagnoses of mild to moderate glaucoma and were mainly Black and Afro-Latino in origin. The patients included in this study were those who underwent early phacoemulsification cataract surgery combined with goniotomy performed with a reusable Sinskey hook (Ambler 200 μm tip) between January 2022 and August 2023 and completed 1 year of follow-up. The primary outcome measures were intraocular pressure, number of medications used, visual acuity, visual field indices, pre-/post-operative spherical refractive error, and adverse events.

Results

A total of 121 eyes were identified with a 1-year follow-up that underwent this combined surgery. The mean age was 65. The mean medically treated pre-operative intraocular pressure ± standard deviation (SD) was lowered from 16.40 ± 4.5 mmHg at baseline to 14.66 ± 3.1 mmHg at 1 year, a statistically significant reduction of 10.6%. There was an 82% reduction in the mean ± SD number of intraocular pressure-lowering medications used, from 1.67 ± 1.2 at baseline to 0.30 ± 0.8 at 1 year. Out of the 121 eyes, 83% (103 eyes) remained medication-free at 1-year post-operation. Post-operatively, there were five IOP spikes (IOP ≥ 30 mmHg) and eight hyphemas that were noted, addressed, and resolved.

Conclusions

Early cataract surgery combined with Sinskey hook goniotomy microinvasive surgery effectively reduced intraocular pressure and medication burden in this cohort of predominantly Black and Afro-Latino patients diagnosed with glaucoma with 1-year follow-up.