University of Colorado School of Medicine, Aurora, CO.
J Glaucoma. 2022 Nov 1;31(11):903-908. doi: 10.1097/IJG.0000000000002099. Epub 2022 Aug 9.
Kahook Dual Blade (KDB) goniotomy can successfully lower intraocular pressure in some patients with uveitis-associated ocular hypertension or glaucoma.
The purpose of this study was to report a case series of patients that underwent KDB goniotomy at a single institution for uveitis-associated ocular hypertension or glaucoma with an open angle.
We performed a retrospective chart review of all patients with uveitis-associated ocular hypertension or glaucoma who underwent KDB goniotomy with trabecular meshwork excision alone or in combination with phacoemulsification cataract surgery at a single center between August 2017 and February 2020. The case series included 45 eyes of 37 patients. All eyes developed ocular hypertension refractory to maximum-tolerated medical therapy and required surgical intervention. Two eyes were excluded as they were lost to follow-up before 5 months postoperatively. Surgical success was defined as reaching the goal intraocular pressure or lower for each patient, including ongoing medical therapy.
At most recent follow-up, 25 (55.6%) of 45 eyes had an intraocular pressure that was at goal. Mean follow-up time was 15.2±12.1 months ranging from 0.5 to 36 months postoperatively, considering that patients were eliminated from the data analysis once they required a second surgery. The mean number of preoperative medications, including oral carbonic anhydrase inhibitors was 3.7±1.2 medications. The mean number of postoperative medications through the last clinic visit was 2.5±1.9 medications for a mean reduction of 1.2±1.6 medications ( P -value <0.0001*).
This larger case series shows that some patients with uveitis-associated ocular hypertension or glaucoma with an open angle may have success with KDB goniotomy.
Kahook 双刀片（KDB）前房角切开术可成功降低葡萄膜炎相关眼压升高或青光眼患者的眼压。
本研究旨在报告在一家机构中接受 KDB 前房角切开术治疗开角型葡萄膜炎相关眼压升高或青光眼的患者的病例系列。
我们对 2017 年 8 月至 2020 年 2 月期间在一家中心接受 KDB 前房角切开术联合小梁网切除术或联合超声乳化白内障吸除术治疗葡萄膜炎相关眼压升高或青光眼的所有患者进行了回顾性图表审查。该病例系列包括 37 例 45 只眼。所有眼均发生了对最大耐受药物治疗有反应的眼压升高，需要手术干预。2 只眼由于术后 5 个月前失访而被排除在外。手术成功定义为每位患者达到目标眼压或更低眼压，包括持续药物治疗。
在最近的随访中，45 只眼中有 25 只（55.6%）眼压达到目标。平均随访时间为 15.2±12.1 个月，范围为术后 0.5 至 36 个月，因为一旦患者需要再次手术，他们就会从数据分析中被排除。术前平均用药数，包括口服碳酸酐酶抑制剂为 3.7±1.2 种药物。截至最后一次就诊，术后平均用药数为 2.5±1.9 种药物，平均减少 1.2±1.6 种药物（P 值<0.0001*）。
本更大的病例系列表明，一些开角型葡萄膜炎相关眼压升高或青光眼患者可能通过 KDB 前房角切开术获得成功。
