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

Anna Barkander; Andrew S Nolan; Gauti Jóhannesson; Mario A Economou

doi:10.2147/OPTH.S468809

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

Clin Ophthalmol. 2024 Jun 24:18:1811-1817. doi: 10.2147/OPTH.S468809. eCollection 2024.

Authors

Anna Barkander^{1

2}, Andrew S Nolan^{1

2}, Gauti Jóhannesson^{1

3

4}, Mario A Economou^{5

6}

Affiliations

¹ Department of Clinical Sciences, Ophthalmology, Umeå University, Umeå, Sweden.
² Department of Ophthalmology, Östersund Hospital, Östersund, Sweden.
³ Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden.
⁴ Department of Ophthalmology, University of Iceland, Reykjavik, Iceland.
⁵ Division of Ophthalmology and Vision, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
⁶ Department of Ophthalmology, Capio Sophiahemmet Hospital, Stockholm, Sweden.

Abstract

Purpose: 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: Kahook Dual Blade; glaucoma; goniotomy; laser trabeculoplasty; phacoemulsification.

Grants and funding

Financial support was provided through grants from the Jämtland-Härjedalen and Västerbotten County Councils and from the Knut and Alice Wallenbergs foundation. None of the supporting organizations had any role in the design or conduct of the research.