RESUMO
PURPOSE: The present study aimed to compare the outcomes of combined phacoemulsification and 360-degree endocyclophotocoagulation with and without goniotomy using a Kahook Dual Blade in patients with glaucoma. PATIENTS AND METHODS: We enrolled 37 patients, 21 of whom underwent combined phacoemulsification with 360-degree endocyclophotocoagulation and goniotomy using a Kahook Dual Blade (tri-modal therapy (T-MT) group). The remaining 16 patients underwent phacoemulsification with endocyclophotocoagulation (bi-modal therapy (B-MT) group). Visual acuity, intraocular pressure, and number of glaucoma medications were recorded before the study and postoperatively on the first day, at week 1, and at 1, 3, 6, 9, and 12 months. Surgical success was defined as an IOP ≤12 mmHg and ≥6 mmHg or an at least 20% reduction in IOP from baseline with (qualified success) or without medications (complete success). RESULTS: Forty-nine eyes were included. Baseline mean IOP was 16.96±3.66 mmHg and 15.64±4.88 mmHg in the T-MT and B-MT groups (p=0.122), respectively. At the 12-month follow-up, mean IOP values were 11.44±2.15 mmHg and 12.45±1.90 mmHg (p=0.031) in the T-MT and B-MT groups, respectively. Complete success rates were 37% in the T-MT group and 31% in the B-MT group, while qualified success rates were 74% and 50%, respectively. Glaucoma medications decreased from 2.0±1.4 to 0.8±1.0 (p<0.001) in the T-MT group and from 1.5±1.3 to 1.0±1.5 in the B-MT group (p=0.032). Similar improvements in visual acuity were observed in both groups. Complications were mild and resolved without intervention. CONCLUSION: The tri-modal treatment is safe and may be more effective in reducing IOP and glaucoma medication requirements than bi-modal treatment.
RESUMO
PURPOSE: To evaluate the effectiveness and agreement of 3 optical biometers in measuring axial length (AL) and biometric parameters in the eyes of patients with mature cataracts. SETTING: Oftalmosalud Instituto de Ojos, Peru. DESIGN: Prospective, comparative study. METHODS: Eyes with mature cataracts were examined. Three consecutive scans were performed with each device: the IOLMaster 700, the Galilei G6, and the Pentacam AXL. The following parameters were recorded: AL, anterior flat keratometry (K1), steep K (K2), anterior astigmatism, mean K (Km), anterior chamber depth (ACD), central corneal thickness (CCT), and lens thickness. Agreement between devices was assessed using the coefficient of correlation of concordance (CCC). RESULTS: Forty-five eyes were included. After 3 attempts, the acquisition success rates in measuring mature cataracts were 84.4% (38/45), 42.2% (19/45), and 37.7% (17/45) for the IOLMaster, the Galilei, and the Pentacam, respectively. Significant differences were found between the Pentacam and the IOLMaster in terms of AL, K2, and CCT. Significant differences were found in terms of K1, K2, Km, ACD, and CCT between the Pentacam and the Galilei; and significant differences were found in AL, K1, Km, and ACD between the Galilei and the IOLMaster (P < .05 all). Good correlations were found between devices (>0.90) in terms of keratometries and AL. CONCLUSIONS: The IOLMaster 700 had the highest AL acquisition success rate when compared with the Pentacam AXL and Galilei G6. Good agreement between devices was found in terms of AL and K readings.