{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:47:42Z","timestamp":1787071662508,"version":"build-2736575974"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","license":[{"start":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T00:00:00Z","timestamp":1758758400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To evaluate the effects of Kahook dual-blade (KDB) goniotomy combined with phacoemulsification on corneal endothelial health and transparency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Prospective comparative study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Sixty-four patients were enrolled: 32 underwent combined KDB goniotomy and phacoemulsification (phaco+KDB), and 32 underwent phacoemulsification alone. Corneal densitometry (CD), endothelial cell density (ECD), central corneal thickness (CCT), coefficient of variation (CV), hexagonality (HEX), and intraocular pressure (IOP) were measured preoperatively and at 1 and 3 months postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The phaco+KDB group demonstrated a significant reduction in IOP postoperatively (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). There were no significant differences between the two groups in the changes in ECD, HEX, CCT, or CV at either postoperative time point (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.05). However, in the phaco+KDB group, CD values demonstrated a statistically significant decrease in the anterior 0\u20132 mm, 2\u20136 mm, and central 0\u20132 mm zones at both 1 and 3 months postoperatively (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>KDB goniotomy combined with phacoemulsification resulted in a similar impact on corneal endothelial parameters as phacoemulsification alone, suggesting no additional endothelial risk. The observed improvement in CD suggests enhanced transparency in the early postoperative period, possibly because of IOP reduction. These findings support the safety of KDB as a microinvasive glaucoma surgery that does not require permanent implants and may offer additional benefits in corneal clarity postoperatively.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_668_25","type":"journal-article","created":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T12:00:20Z","timestamp":1758801620000},"page":"1491-1496","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["A quantitative assessment of the corneal endothelium and transparency after Kahook dual blade goniotomy combined with phacoemulsification"],"prefix":"10.4103","volume":"73","author":[{"given":"Mahmut","family":"Asfuro\u011flu","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Ankara Bilkent City Hospital, Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonca","family":"Asfuro\u011flu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Ankara Bilkent City Hospital, Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cenk Zeki","family":"Fikret","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Ankara Bilkent City Hospital, Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,9,25]]},"reference":[{"key":"R1-20260420","doi-asserted-by":"crossref","first-page":"59","DOI":"10.5005\/jp-journals-10078-1352","article-title":"A review of excisional goniotomy performed with the kahook dual blade for glaucoma management","volume":"16","author":"Dorairaj","year":"2022","journal-title":"J Curr Glaucoma Pract"},{"key":"R2-20260420","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1016\/j.jcrs.2017.06.046","article-title":"Goniotomy with a single-use dual blade: Short-term results","volume":"43","author":"Greenwood","year":"2017","journal-title":"J Cataract Refract Surg"},{"key":"R3-20260420","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1136\/bjophthalmol-2018-313417","article-title":"Effect of trabeculectomy on corneal endothelial cell loss","volume":"104","author":"Hirooka","year":"2020","journal-title":"Br J Ophthalmol"},{"key":"R4-20260420","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.ajo.2023.03.038","article-title":"Different patterns in the corneal endothelial cell loss after pars plana and pars limbal insertion of the Baerveldt glaucoma implant","volume":"253","author":"Chihara","year":"2023","journal-title":"Am J Ophthalmol"},{"key":"R5-20260420","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.ajo.2019.07.016","article-title":"Corneal endothelial cell loss and morphometric changes 5 years after phacoemulsification with or without cypass micro-stent","volume":"208","author":"Lass","year":"2019","journal-title":"Am J Ophthalmol"},{"key":"R6-20260420","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1186\/s12886-018-0998-5","article-title":"Quantitative evaluation of corneal epithelial edema after cataract surgery using corneal densitometry: A prospective study","volume":"18","author":"Ishikawa","year":"2018","journal-title":"BMC Ophthalmol"},{"key":"R7-20260420","doi-asserted-by":"crossref","first-page":"741","DOI":"10.3928\/1081597X-20210802-01","article-title":"Epithelial flap corneal cross-linking","volume":"37","author":"Borroni","year":"2021","journal-title":"J Refract Surg"},{"key":"R8-20260420","first-page":"52","article-title":"Clinical decisions in glaucoma","volume":"5","author":"Hodapp","year":"1993","journal-title":"Mosby"},{"key":"R9-20260420","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1001\/archopht.1993.01090060119035","article-title":"The Lens Opacities Classification System III. The Longitudinal Study of Cataract Study Group","volume":"111","author":"Chylack","year":"1993","journal-title":"Arch Ophthalmol"},{"key":"R10-20260420","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1167\/iovs.13-13236","article-title":"Normative values for corneal densitometry analysis by Scheimpflug optical assessment","volume":"55","author":"N\u00ed Dhubhghaill","year":"2014","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"R11-20260420","doi-asserted-by":"crossref","first-page":"50","DOI":"10.4103\/joco.joco_173_21","article-title":"Repeatability of corneal densitometry measurements using a scheimpflug camera in healthy normal corneas","volume":"34","author":"Pakbin","year":"2022","journal-title":"J Curr Ophthalmol"},{"key":"R12-20260420","doi-asserted-by":"crossref","first-page":"715","DOI":"10.2147\/OPTH.S196105","article-title":"Outcome of phacoemulsification combined with excisional goniotomy using the Kahook Dual Blade in severe glaucoma patients at 6 months","volume":"13","author":"Hirabayashi","year":"2019","journal-title":"Clin Ophthalmol"},{"key":"R13-20260420","doi-asserted-by":"crossref","first-page":"2093","DOI":"10.1007\/s12325-018-0803-0","article-title":"Six-month outcomes of goniotomy performed with the Kahook Dual blade as a stand-alone glaucoma procedure","volume":"35","author":"Berdahl","year":"2018","journal-title":"Adv Ther"},{"key":"R14-20260420","doi-asserted-by":"crossref","first-page":"2515","DOI":"10.1007\/s12325-019-01025-1","article-title":"12-month retrospective comparison of Kahook dual blade excisional goniotomy with \u0131stent trabecular bypass device \u0131mplantation in glaucomatous eyes at the time of cataract surgery","volume":"36","author":"ElMallah","year":"2019","journal-title":"Adv Ther"},{"key":"R15-20260420","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1097\/ICO.0000000000002439","article-title":"Scheimpflug corneal densitometry changes after trabeculectomy","volume":"40","author":"Pillunat","year":"2021","journal-title":"Cornea"},{"key":"R16-20260420","doi-asserted-by":"crossref","first-page":"108137","DOI":"10.1016\/j.exer.2020.108137","article-title":"Composition, structure and function of the corneal stroma","volume":"198","author":"Espana","year":"2020","journal-title":"Exp Eye Res"},{"key":"R17-20260420","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1038\/s41433-024-02969-7","article-title":"Structural control of corneal transparency, refractive power and dynamics","volume":"39","author":"Meek","year":"2025","journal-title":"Eye"},{"key":"R18-20260420","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1016\/j.jcjo.2018.08.005","article-title":"Long-term (\u226510 years) results of corneal endothelial cell loss after cataract surgery","volume":"54","author":"Choi","year":"2019","journal-title":"Can J Ophthalmol"},{"key":"R19-20260420","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1136\/bjophthalmol-2018-313723","article-title":"Comparison of changes in corneal endothelial cell density and central corneal thickness between conventional and femtosecond laser-assisted cataract surgery: A randomised, controlled clinical trial","volume":"104","author":"Dzhaber","year":"2020","journal-title":"Br J Ophthalmol"},{"key":"R20-20260420","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1097\/IJG.0000000000001430","article-title":"Impact of phacoemulsification combined with XEN gel stent \u0131mplantation on corneal endothelial cell density: 2-year results","volume":"29","author":"Gillmann","year":"2020","journal-title":"J Glaucoma"},{"key":"R21-20260420","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1097\/IJG.0000000000001546","article-title":"A prospective analysis of istent \u0131nject microstent \u0131mplantation: Surgical outcomes, endothelial cell density, and device position at 12 months","volume":"29","author":"Gillmann","year":"2020","journal-title":"J Glaucoma"},{"key":"R22-20260420","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1016\/j.ophtha.2019.03.006","article-title":"Prospective, randomized, controlled pivotal trial of an ab \u0131nterno \u0131mplanted trabecular micro-bypass in primary open-angle glaucoma and cataract: Two-year results","volume":"126","author":"Samuelson","year":"2019","journal-title":"Ophthalmology"},{"key":"R23-20260420","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1097\/IJG.0000000000001128","article-title":"The \u0131nfluence of trabectome surgery on corneal endothelial cells","volume":"28","author":"Kasahara","year":"2019","journal-title":"J Glaucoma"},{"key":"R24-20260420","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1097\/j.jcrs.0000000000001365","article-title":"Corneal endothelial safety profile in minimally invasive glaucoma surgery","volume":"50","author":"Ahmed","year":"2024","journal-title":"J Cataract Refract Surg"},{"key":"R25-20260420","doi-asserted-by":"crossref","first-page":"4047","DOI":"10.2147\/OPTH.S263072","article-title":"Corneal endothelial cell changes after phacoemulsification combined with excisional goniotomy with the Kahook dual blade or iStent: A prospective fellow-eye comparison","volume":"14","author":"Dorairaj","year":"2020","journal-title":"Clin Ophthalmol"},{"key":"R26-20260420","doi-asserted-by":"crossref","first-page":"2771","DOI":"10.1007\/s00417-021-05213-0","article-title":"Twelve-month results of ab interno trabeculectomy with Kahook Dual Blade: An interventional, randomized, controlled clinical study","volume":"259","author":"Ventura-Abreu","year":"2021","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"R27-20260420","doi-asserted-by":"crossref","first-page":"170","DOI":"10.18502\/jovr.v17i2.10787","article-title":"An alternate technique for goniotomy: Description of procedure and preliminary results","volume":"17","author":"Shute","year":"2022","journal-title":"J Ophthalmic Vis Res"},{"key":"R28-20260420","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.4103\/IJO.IJO_1072_24","article-title":"Outcomes of bent ab interno needle goniectomy with phacoemulsification in moderate to severe primary open angle glaucoma","volume":"72","author":"Bukke","year":"2024","journal-title":"Indian J Ophthalmol"},{"key":"R29-20260420","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.ajo.2018.10.002","article-title":"Corneal densitometry as a predictive diagnostic tool for visual acuity results after descemet membrane endothelial keratoplasty","volume":"198","author":"Schaub","year":"2019","journal-title":"Am J Ophthalmol"},{"key":"R30-20260420","doi-asserted-by":"crossref","first-page":"521078","DOI":"10.3389\/fmed.2020.521078","article-title":"Corneal densitometry after small \u0131ncision lenticule extraction (SMILE) and Femtosecond Laser-Assisted LASIK (FS-LASIK): 5-year prospective comparative study","volume":"7","author":"Wei","year":"2020","journal-title":"Front Med (Lausanne)"},{"key":"R31-20260420","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1016\/j.jfo.2019.11.035","article-title":"Corneal densitometry and topography in patients with primary congenital glaucoma","volume":"43","author":"Morales-Fern\u00e1ndez","year":"2020","journal-title":"J Fr Ophtalmol"},{"key":"R32-20260420","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1016\/j.jcjo.2021.01.009","article-title":"Corneal densitometry and biomechanical properties in patients with primary congenital glaucoma","volume":"56","author":"Morales-Fern\u00e1ndez","year":"2021","journal-title":"Can J Ophthalmol"},{"key":"R33-20260420","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1097\/ICO.0000000000002762","article-title":"Scheimpflug corneal densitometry values and severity of guttae in relation to visual acuity in fuchs endothelial corneal dystrophy","volume":"41","author":"Shah","year":"2022","journal-title":"Cornea"},{"key":"R34-20260420","doi-asserted-by":"crossref","first-page":"3279","DOI":"10.3390\/jcm12093279","article-title":"Vision-related quality of life following combined cataract and minimally \u0131nvasive glaucoma surgery or cataract surgery alone in glaucoma patients","volume":"12","author":"Yuasa","year":"2023","journal-title":"J Clin Med"},{"key":"R35-20260420","first-page":"381","article-title":"Preoperative ocular biometric parameters as predictors of \u0131ntraocular pressure reduction after phacoemulsification cataract surgery in non-glaucomatous eyes","volume":"15","author":"Uzun","year":"2025","journal-title":"Life (Basel)"}],"container-title":["Indian Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_668_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:50:38Z","timestamp":1787068238000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_668_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,25]]},"references-count":35,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/ijo.ijo_668_25","relation":{},"ISSN":["0301-4738","1998-3689"],"issn-type":[{"value":"0301-4738","type":"print"},{"value":"1998-3689","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,25]]},"assertion":[{"value":"2025-03-12","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-22","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}