This was a retrospective chart review comparing all patients undergoing KDB goniotomy between January 2016 and March 2020 at New York Eye and Ear Infirmary of Mount Sinai and Trabectome between January 2013 and December 2019 at Yale Eye Center, both in combination with cataract surgery. This study was approved by the Mount Sinai Institutional Review Board (IRB) (IRB-20-03241) and the Yale IRB (IRB-2000026321). Patient consent to review medical records was not required by the Mount Sinai IRB and the Yale IRB, as the use or disclosure of patient health information involved no more than a minimal risk to the privacy of individuals. All efforts were made to maintain patient data confidentiality including use of an encrypted local database and an adequate plan to destroy patient identifiers at the earliest opportunity consistent with the conduct of research. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committees and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Data were collected from subjects aged 18 years or older with at least 1 month of follow-up after surgery. All glaucoma subtypes and severities were included, along with patients with history of selective laser trabeculoplasty (SLT) or argon laser trabeculoplasty (ALT). Exclusion criteria included age less than 18 years, having prior intraocular surgery, and having additional glaucoma surgery performed at the time of KDB or Trabectome with cataract surgery or within 12 months of the initial surgery.
Patient demographics and pre-operative characteristics were gathered. Visual acuity was evaluated via Snellen chart, intraocular pressure (IOP) via Goldmann applanation tonometry, visual fields via 24–2 Humphrey visual field, anterior segment via slit-lamp examination, and posterior segment via dilated fundus examination. Medication regimens were determined at the discretion of each surgeon but included the following medications: bimatoprost, brimonidine, brinzolamide, dorzolamide, latanoprost, methazolamide, netarsudil, pilocarpine, tafluprost, timolol, travoprost, and unoprostone. IOP and number of medications were collected from the visits closest to post-operative month 1 (POM1), month 6 (POM6), and month 12 (POM12) following surgery. Complications including hyphema, IOP elevation greater than 10 mmHg above pre-operative value, ciliary body detachment, hypotony, aqueous misdirection, wound leak, and postoperative infection were recorded. Hyphema was defined as either dispersed or layering and was recorded on post-operative day 1 (POD1). All grades of hyphemas including microhyphema were recorded. Anticoagulation use was recorded categorically in patients taking acetylsalicylic acid, clopidogrel, direct oral anticoagulants, or warfarin. Chart documentation was completed by each individual surgeon. The Enhanced Glaucoma Severity Staging system was used to grade severity.13 (link) Success was defined as an IOP <21 mmHg and at least 20% reduction in IOP at POM12.
Data were collected from subjects aged 18 years or older with at least 1 month of follow-up after surgery. All glaucoma subtypes and severities were included, along with patients with history of selective laser trabeculoplasty (SLT) or argon laser trabeculoplasty (ALT). Exclusion criteria included age less than 18 years, having prior intraocular surgery, and having additional glaucoma surgery performed at the time of KDB or Trabectome with cataract surgery or within 12 months of the initial surgery.
Patient demographics and pre-operative characteristics were gathered. Visual acuity was evaluated via Snellen chart, intraocular pressure (IOP) via Goldmann applanation tonometry, visual fields via 24–2 Humphrey visual field, anterior segment via slit-lamp examination, and posterior segment via dilated fundus examination. Medication regimens were determined at the discretion of each surgeon but included the following medications: bimatoprost, brimonidine, brinzolamide, dorzolamide, latanoprost, methazolamide, netarsudil, pilocarpine, tafluprost, timolol, travoprost, and unoprostone. IOP and number of medications were collected from the visits closest to post-operative month 1 (POM1), month 6 (POM6), and month 12 (POM12) following surgery. Complications including hyphema, IOP elevation greater than 10 mmHg above pre-operative value, ciliary body detachment, hypotony, aqueous misdirection, wound leak, and postoperative infection were recorded. Hyphema was defined as either dispersed or layering and was recorded on post-operative day 1 (POD1). All grades of hyphemas including microhyphema were recorded. Anticoagulation use was recorded categorically in patients taking acetylsalicylic acid, clopidogrel, direct oral anticoagulants, or warfarin. Chart documentation was completed by each individual surgeon. The Enhanced Glaucoma Severity Staging system was used to grade severity.13 (link) Success was defined as an IOP <21 mmHg and at least 20% reduction in IOP at POM12.
