Albuainain Abdulrahman, Al Habash Ahmed
Eye and Laser Centre, Bahrain Defense Force Hospital, Royal Medical Services, Riffa, Kingdom of Bahrain.
Department of Ophthalmology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia.
Saudi J Ophthalmol. 2022 Aug 29;36(2):213-217. doi: 10.4103/sjopt.sjopt_182_21. eCollection 2022 Apr-Jun.
The aim of this study was to describe the changes in intraocular pressure (IOP), IOP-reducing drugs, 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 (KDB-phaco) by a single surgeon in Saudi Arabia.
The health records of 55 eyes of 47 patients undergoing KDB-phaco by a single surgeon were reviewed. Data were extracted from visits occurring preoperatively ( = 55), intraoperatively ( = 55), and 1-day ( = 55), 2 weeks ( = 55), 4-6 weeks ( = 49), 2-3 months ( = 55), and 6 ( = 55), 9 ( = 55), 12 ( = 55), 18 ( = 49), 24 ( = 46), and 36 months ( = 16) postoperatively. Data collection included IOP, IOP-lowering medications, and VA at each time point. Adverse events were also collected. Paired -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 (minimum 12 months, mean 26.1 [1.0] months) ranged from 13.6 to 14.1 mmHg; significant reductions ( < 0.0007) of 5.7-7.0 mmHg (23.0%-29.5%) were achieved at every time point. Medications were reduced from 3.2 (0.1) to 0.2-2.0 (reductions of 1.2-3.1 medications [50.0%-94.9%]; < 0.0001 at every time point). At months 24 and 36, the mean IOP was 13.9 (0.3) and 13.9 (0.5) mmHg and mean medications were 1.4 (0.2) and 2.0 (0.4). Mean logMAR VA improved from 1.0 (0.1) preoperatively to (0.2 [0.0]; < 0.001) by month 6 and remained stable thereafter through the duration of follow-up.
KDB-phaco significantly lowered IOP approximately 30% by day 1 with consistency and durability through 3 years. Medication use was reduced by >50% through 36 months. Mean logMAR VA improved from 1.0 to 0.2 (Snellen equivalent 20/200-20/32). This procedure provides meaningful long-term reductions in IOP and the need for IOP-lowering medications without compromising visual rehabilitation in Saudi Arabian eyes with cataract and glaucoma.
本研究旨在描述沙特阿拉伯一位外科医生对接受卡胡克双刃刀（KDB）超声乳化联合房角切开术（KDB - 超声乳化）的患者进行长达3年随访期间的眼压（IOP）、降眼压药物及视力（VA）的变化情况。
回顾了一位外科医生为47例患者实施KDB - 超声乳化手术的55只眼睛的健康记录。数据提取自术前（n = 55）、术中（n = 55）以及术后1天（n = 55）、2周（n = 55）、4 - 6周（n = 49）、2 - 3个月（n = 55）、6个月（n = 55）、9个月（n = 55）、12个月（n = 55）、18个月（n = 49）、24个月（n = 46）和36个月（n = 16）的就诊记录。数据收集包括每个时间点的眼压、降眼压药物及视力。还收集了不良事件。采用配对t检验比较每个时间点的眼压、药物及视力与术前值。
平均（标准误）基线眼压为20.4（0.7）mmHg，在长达36个月的随访期间（最短12个月，平均26.1 [1.0]个月），眼压范围为13.6至14.1 mmHg；每个时间点眼压均显著降低（P < 0.0007）5.7 - 7.0 mmHg（23.0% - 29.5%）。药物使用从3.2（0.1）种减少至0.2 - 2.0种（减少1.2 - 3.1种药物[50.0% - 94.9%]；每个时间点P < 0.0001）。在24个月和36个月时，平均眼压分别为13.9（0.3）mmHg和13.9（0.5）mmHg，平均药物使用分别为1.4（0.2）种和2.0（0.4）种。平均logMAR视力从术前的1.0（0.）改善至6个月时的0.2（0.0）（P < 0.001），此后在随访期间保持稳定。
KDB - 超声乳化在术后1天可使眼压显著降低约30%，并在3年内保持稳定和持久。36个月内药物使用减少超过50%。平均logMAR视力从1.0改善至0.2（相当于Snellen视力表的20/200 - 20/32）。该手术可在不影响沙特阿拉伯患有白内障和青光眼患者视力恢复的情况下，实现眼压的长期有效降低以及减少降眼压药物的使用。
