1 Year Outcomes Of Excisional Goniotomy With Trabex + Combined With Phacoemulsification In Bolivia

To characterize intraocular pressure (IOP) and IOP-lowering medication reductions through 12 months following excisional goniotomy (EG) using the TrabEx + (MicroSurgical Technologies) combined with phacoemulsification in Bolivia.

This was a retrospective analysis of patients undergoing KDB-phaco at Clínica de Ojos Norte in Santa Cruz de la Sierra, Bolivia, between July 2022 and october 2023. The protocol for data collection and analysis was reviewed and approved by the Bolivian Glaucoma Society Ethics Committee, which granted a waiver of consent.

This was a single-surgeon, retrospective analysis. Preoperative and postoperative IOP and medication use data were collected through 1 year of follow-up. Changes from baseline were analyzed using paired t-tests.

Overall, 18 eyes of 18 patients were included; all were seen through 1 year of follow-up. Their mean (standard deviation) age was 67.2 (6.1) years, and most had primary open-angle glaucoma (63.3%) or pseudoexfoliation glaucoma (33.3%). Mean preoperative IOP was 20.5 (2.9) mmHg with subjects using a mean of 1.5 medications per eye. Across time points (1, 3, 6 and 12 months), mean IOP ranged from 14.1-14.8 mmHg (p<0.0001 at all-time points). At 1 year postoperatively, mean IOP was 14.2 mmHg (a reduction of 6.3 mmHg, 30.7%, p<0.0001) and mean medication use was 0.22 medications per eye (a reduction of 1.28 medications, 85.33%, p<0.0001). with 83.3% medication-free.

Consistent with prior reports, excisional goniotomy lowered IOP by 31% and medications by 80 % 12 months postoperatively. These are both statistically significant and clinically significant therapeutic outcomes.

Excisional goniotomy combined with phacoemulsification provides reductions in both IOP and the need for IOP-lowering medications in eyes with primary open angle glaucoma or pseudoexfoliation glaucoma in Bolivia.