Clinical Ophthalmology (Jun 2024)

Influence of Laser Trabeculoplasty on Combined Phacoemulsification/Kahook Dual Blade Goniotomy

  • Barkander A,
  • Nolan AS,
  • Jóhannesson G,
  • Economou MA

Journal volume & issue
Vol. Volume 18
pp. 1811 – 1817

Abstract

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Anna Barkander,1,2 Andrew S Nolan,1,2 Gauti Jóhannesson,1,3,4 Mario A Economou5,6 1Department of Clinical Sciences, Ophthalmology, Umeå University, Umeå, Sweden; 2Department of Ophthalmology, Östersund Hospital, Östersund, Sweden; 3Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden; 4Department of Ophthalmology, University of Iceland, Reykjavik, Iceland; 5Division of Ophthalmology and Vision, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; 6Department of Ophthalmology, Capio Sophiahemmet Hospital, Stockholm, SwedenCorrespondence: Anna Barkander, Department of Clinical Sciences, Ophthalmology Umeå University, SE-901 85, Umeå, Sweden, Tel +46 63 15 30 00, Email [email protected]: To investigate the influence of laser trabeculoplasty (LTP) on subsequent surgery with combined phacoemulsification/Kahook Dual Blade goniotomy (phaco-KDB) in patients with open-angle glaucoma or intraocular hypertension.Patients and Methods: Patients undergoing phaco-KDB between 2019 and 2021 were divided into previously LTP treated and previously non-LTP treated, and LTP-treatment included argon laser trabeculoplasty (ALT) and selective laser trabeculoplasty (SLT). The primary goal was to investigate if previous LTP influenced later surgical outcome of phaco-KDB. The secondary goal was to investigate if the outcome of LTP could be predictive of the outcome of subsequent phaco-KDB. We also compared IOP- and medication reductions between LTP and non-LTP treated patients.Results: A total of 111 LTP treated patients were compared to 139 non-LTP treated patients. In LTP treated patients, surgical success of phaco-KDB was 82.9%, compared to 88.5% in non-LTP treated patients (P=0.20). Reductions in IOP and medications were similar between groups. Furthermore, within the LTP group, patients with successful LTP-treatment had a subsequent surgical success of phaco-KDB in 80.7%, compared to 83.0% in patients with unsuccessful LTP-treatment (P=0.765).Conclusion: Previous LTP treatment does not predict the outcome of phaco-KDB. Furthermore, no correlation was found between the LTP effect and a later surgical success of phaco-KDB.Keywords: laser trabeculoplasty, Kahook Dual Blade, goniotomy, glaucoma, phacoemulsification

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