Early Results of Goniotomy with the Kahook Dual Blade, a Novel Device for the Treatment of Glaucoma

Abstract

Purpose

To report the outcomes of patients who underwent goniotomy with the Kahook Dual Blade (KDB) either as a standalone procedure or in combination with cataract extraction.

Patients and methods

This retrospective chart review included 111 eyes of 90 patients who underwent KDB goniotomy from January to November 2016 at Glaucoma Associates of Texas. KDB goniotomy was combined with cataract surgery in 100 eyes. The main outcome measures were postoperative intraocular pressure (IOP) and number of IOP lowering medications.

Results

Preoperatively, mean IOP was 17.1 ± 4.7 mmHg (range 8–34 mmHg) and mean number of IOP lowering medications was 2.4 ± 1.3 (range 0–6). Postoperatively, mean IOP was 14.9 mmHg, 13.9 mmHg, 14.1 mmHg, 14.4 mmHg, and 14.7 mmHg at 1, 3, 6, 9, and 12 months follow-up, respectively (all p <0.004). Mean numbers of IOP lowering medications were 0.8, 1.0, 1.0, 1.0, and 1.6 at 1, 3, 6, 9, and 12 months follow-up, respectively (all p <0.001). The cumulative reoperation rates for uncontrolled IOP after KDB were 0%, 1.0%, 2.1%, and 4.6% at 3, 6, 9, and 12 months, respectively. Eyes with a preoperative IOP >21 mmHg were significantly more likely to undergo reoperation (p = 0.038, log-rank test). There were no serious complications at any time point in the follow-up period.

Conclusion

The Kahook Dual Blade results in a reduction in IOP and use of glaucoma medications after one year of follow-up. Further prospective studies are needed to fully characterize safety and efficacy.

Keywords:

• goniotomy
• kahook dual blade
• minimally invasive

Précis

Goniotomy with the Kahook Dual Blade can be performed alone or in combination with cataract surgery and results in a decrease in intraocular pressure and glaucoma medication use.

Disclosure

DSG (consultant and speaker for New World Medical) and OS (consultant to New World Medical). The authors report no other conflicts of interest in this work.