One-Year Outcomes Of Phacoemulsification Combined With Goniotomy And Transluminal Dilation Using The Streamline Surgical System

To evaluate safety and efficacy outcomes of the STREAMLINE Surgical System a device which creates precise incisions and localized goniotomies through the trabecular meshwork while performing transluminal dilation, when combined with phacoemulsification.

This was a noncomparative, two-surgeon, retrospective chart review performed at a tertiary care hospital setting. 

31 eyes that underwent transluminal dilation and goniotomy with STREAMLINE and concomitant phacoemulsification were retrospectively identified. All eyes had primary open angle glaucoma (POAG). Primary outcomes included changes from baseline in intraocular pressure (IOP) and number of glaucoma medications at 1, 3, 6, 9, and 12 months, analyzed with paired sample t-tests. Secondary outcomes included the percentage of eyes achieving reduction in glaucoma medication burden by > 1 medication and/or > 20% IOP reduction from baseline at 12 months. 

At 12 months, the mean IOP was reduced from 18.1 + 5.5 mmHg to 13.8 + 4.9 mmHg (-24%; p<0.05) and mean number of glaucoma medications was reduced from 1.7 + 1.4 to 0.6 + 1.1 (-63%; p<0.0001). When compared to baseline, 88% of eyes experienced reduction by > 1 glaucoma medication and 44% of eyes achieved > 20% IOP reduction. No vision-threatening complications were observed.

Goniotomy and transluminal dilation with STREAMLINE combined with phacoemulsification significantly reduced IOP and lowered glaucoma medication dependence in eyes with POAG. Overall, this combined procedure appears safe and effective in the treatment of POAG, for up to 12 months.