HARVARD DEPARTMENT OF OPHTHALMOLOGY
Category : Clinical Research Candidate : Henisk Falah Poster #: C5
Comparative Outcomes of Phacoemulsification Combined with Hydrus or Kahook Dual Blade
Blake Oberfeld , BS ; Nathan Eli Hall , MS ; Henisk Falah David Solá-Del Valle , MD
Purpose : To report the relative efficacy of combining phacoemulsification with Schlemm canal microstent ( Phaco / Hydrus ) or dual blade trabecular excision ( Phaco / KDB ).
Methods : Phaco / Hydrus or Phaco / KDB procedures from January 2016 to July 2021 were included . Data were collected as available for 36 months postoperatively . Primary outcomes were IOP and medication burden evaluated by Generalized Estimating Equations ( GEE ). Two Kaplan-Meier Estimates ( KM ) assessed survival without additional glaucoma procedure or medication while maintaining : ( 1 ) IOP ≤21 mmHg and ≥20 % IOP reduction or ( 2 ) IOP ≤ preoperatively designated goal .
Results : Mean preoperative IOP was 17.70 mmHg ± 4.91 ( SD ) on 0.28 ± 0.86 medications in the Phaco / Hydrus cohort ( N = 69 ) and 15.92 ± 4.34 mmHg on 0.19 ± 0.70 medications in the Phaco / KDB cohort ( N = 62 ). At 12 months , mean IOP was reduced to 14.98 ± 2.77 mmHg on 0.12 ± 0.60 medications after Phaco / Hydrus and 13.52 ± 4.13 mmHg on 0.04 ± 0.19 medications after Phaco / KDB . GEE models of IOP ( p < 0.001 ) and medication burden ( p = 0.05 ) had significant patterns of reduction across all timepoints . There was no difference in the reduction in IOP ( p = 0.94 ) or medication burden ( p = 0.95 ) when evaluated between procedures . Phaco / Hydrus and Phaco / KDB were not different in survival by KM1 ( p = 0.72 ) or KM2 ( p = 0.11 ).
Conclusions : Both Phaco / Hydrus and Phaco / KDB resulted in significantly reduced IOP and medication burden for more than 12 months . Phaco / Hydrus and Phaco / KDB confer similar