ArticleGraefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie2026
Predictive baseline thresholds for successful dual blade goniotomy combined with phacoemulsification in glaucoma patients.
Article in Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo define preoperative thresholds of intraocular pressure (IOP) and the number of IOP-lowering eye drops that may predict surgical success following Kahook Dual Blade goniotomy combined with phacoemulsification (Phaco-KDB) in patients with glaucoma and cataract.
methodsThis retrospective study analysed 307 eyes of 307 patients undergoing Phaco-KDB. Data on demographics, glaucoma type, IOP, number of IOP-lowering medications and complications were collected over 18 months of follow-up. Complete success was defined as IOP ≤ 21, 18, 15 or 12 mmHg without medications; qualified success allowed for ongoing topical IOP-lowering therapy. Logistic regression models were used to determine predictive thresholds.
resultsMean baseline IOP was 18.6 ± 5.2 mmHg and decreased to 15.0 ± 4.4 mmHg at 18 months. The mean number of IOP-lowering medications was reduced from 2.2 ± 1.1 to 1.7 ± 1.4. For qualified success, the identified preoperative IOP thresholds were 27.2 mmHg for achieving ≤ 21 mmHg (AUC = 0.900, p < 0.001), 25.1 mmHg for ≤ 18 mmHg (AUC = 0.8604, p < 0.001), 19.8 mmHg for ≤ 15 mmHg (AUC = 0.7752, p < 0.001), and 13.5 mmHg for ≤ 12 mmHg (AUC = 0.7772, p = 0.0011). For complete success, the threshold IOP values were 20.6 mmHg for ≤ 21 mmHg (AUC = 0.7893, p < 0.001), 18.1 mmHg for ≤ 18 mmHg (AUC = 0.7365, p < 0.001), and 15.0 mmHg for ≤ 15 mmHg (AUC = 0.5890, p = 0.0109). No significant association was found between the number of preoperative medications and surgical outcome.
conclusionsPreoperative IOP is a significant predictor of Phaco-KDB success. Our findings suggest that Phaco-KDB primarily stabilizes IOP at preoperative levels while reducing the need for IOP-lowering therapy, rather than achieving substantial additional IOP reduction.
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