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Long-term follow-up of combined phacoemulsification and excisional goniotomy with the kahook dual blade in patients with cataract and glaucoma in Saudi Arabia

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First Author: A.Al Habash SAUDI ARABIA

Co Author(s):    A. Al Bainain                    

Abstract Details


To characterize the changes in intraocular pressure (IOP), IOP-lowering medications, and visual acuity (VA) through up to 3 years of follow-up in patients undergoing combined phacoemulsification and excisional goniotomy with the Kahook Dual Blade (phaco-KDB) by a single surgeon in Saudi Arabia.


King Fahd Hospital of the University, Khobar, Saudi Arabia.


The health records of 55 eyes of 47 patients undergoing phaco-KDB by a single surgeon were reviewed. Data were extracted from visits occurring preoperatively (n=55), intraoperatively (n=55), and 1 day (n=55), 2 weeks (n=55), 4-6 weeks (n=49), 2-3 months (n=55), and 6 (n=55), 9 (n=55), 12 (n=55), 18 (n=49), 24 (n=46), and 36 months (n=16) postoperatively. Data collection included IOP, IOP-lowering medications, and VA at each time point. Adverse events were also collected. Paired t-tests were used to compare IOP, medications, and VA at each time point to preoperative values.


Mean (standard error) baseline IOP was 20.4 (0.7) mmHg and through up to 36 months of follow-up ranged from 13.6 to 14.1 mmHg; significant reductions (p<0.001) of 5.7-6.8 mmHg (28.8-33.8%) were achieved at every time point. Medications were reduced from 3.2 (0.1) to 0.2-2.0 (minus 1.2-3.0 medications [37.6-94.8%]; p<0.001 at every time point). At Months 24 and 36, mean IOP was 13.9 (0.3) and 13.9 (0.5) mmHg (p<0.001); mean medications were 1.4 (0.2) and 2.0 (0.4) (p<0.001). Mean logMAR VA improved from 1.0 (0.1) preoperatively to (0.2 [0.0]; p<0.001) by Month 6, remaining stable thereafter.


Phaco-KDB significantly lowered IOP approximately 30% by Day 1 with consistency and durability through 3 years. Medication use was reduced by >50% at 24 months and 38% at 36 months. Mean logMAR VA improved from 1.0 to 0.2 (Snellen equivalent 20/200 to 20/32). This procedure provides meaningful visual rehabilitation with long-term reductions in IOP and the need for IOP-lowering medications in Saudi Arabian eyes with cataract and glaucoma.

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