Twelve-month outcomes of excisional goniotomy using the Kahook Dual Blade^® in eyes with angle-closure glaucoma

Figures & data

Figure 1 The Kahook Dual Blade. Its tip features a ramp with two parallel blades to engage and excise a strip of trabecular meshwork as it is advanced along the circumference of the iridocorneal angle.

Table 1 Demographic and glaucoma severity data of the study cohort

		(N=24 subjects)
Age, yr (mean (SE))		66.5 (2.4)
Gender (n (%))	Female	13 (54.2)
	Male	11 (45.8)
		(N=42 eyes)
Severity (n (%))	Mild	3 (7.1)
	Moderate	13 (31.0)
	Severe	26 (61.9)
Glaucoma medications (n (%))	1	4 (9.5)
	2	20 (47.6)
	3	18 (42.9)
Study eye (n (%))	Right eye	20 (47.6)
	Left eye	22 (52.4)

Table 2 Mean IOP, medication and visual acuity data, and changes from baseline, at each study time point

	Baseline	Day 1	Week 1	Month 1	Month 3	Month 6	Month 9	Month 12
	N=42	N=42	N=42	N=42	N=42	N=42	N=42	N=42
Mean IOP (SE)	25.5 (0.73)	15.4 (0.82)	13.5 (0.61)	12.9 (0.46)	12.7 (0.35)	12.8 (0.43)	12.8 (0.35)	13.3 (0.44)
Change from baseline	–	−10.1 (0.98)	−12.0 (0.82)	−12.6 (0.69)	−12.8 (0.67)	−12.7 (0.75)	−12.8 (0.66)	−12.3 (0.73)
Percent change from baseline	–	−38.4 (3.26)	−45.9 (2.53)	−48.5 (1.76)	−49.5 (1.46)	−48.8 (1.86)	−49.2 (1.48)	−47.2 (1.61)
Significance	–	<0.0001	<0.0001	<0.0001	<0.0001	<0.0001	<0.0001	<0.0001
Mean number of IOP-lowering medications (SE)	2.33 (0.10)	–	–	0.10 (0.06)	0.05 (0.03)	0.14 (0.06)	0.10 (0.05)	0.14 (0.06)
Change from baseline	–	–	–	−2.24 (0.10)	−2.29 (0.10)	−2.19 (0.12)	−2.23 (0.12)	−2.19 (0.12)
Percent change from baseline	–	–	–	−96.8 (1.90)	−98.4 (1.11)	−91.7 (3.65)	−93.3 (3.55)	−91.7 (3.65)
Significance	–	–	–	<0.0001	<0.0001	<0.0001	<0.0001	<0.0001
Mean logMAR best-corrected visual acuity (SE)	0.547 (0.06)	0.405 (0.09)	0.252 (0.07)	0.210 (0.07)	0.183 (0.07)	0.183 (0.07)	0.171 (0.07)	0.159 (0.07)
Change from baseline	–	−0.141 (0.06)	−0.295 (0.02)	−0.337 (0.03)	−0.363 (0.03)	−0.364 (0.03)	−0.376 (0.03)	−0.388 (0.03)
Percent change from baseline	–	−33.1 (11.68)	−65.0 (4.79)	−73.1 (4.69)	−77.8 (4.03)	−77.6 (4.32)	−79.3 (4.32)	−81.7 (4.45)
Significance	–	0.0072	<0.0001	<0.0001	<0.0001	<0.0001	<0.0001	<0.0001

Table 3 Pre-specified IOP and medication outcomes at each study time point

	Day 1 (N=42)	Week 1 (N=42)	Month 1 (N=42)	Month 3 (N=42)	Month 6 (N=42)	Month 9 (N=42)	Month 12 (N=42)
Proportion achieving IOP ≤18 mmHg	31 (73.8)	37 (88.1)	41 (97.6)	42 (100)	39 (92.9)	42 (100)	39 (92.9)
Proportion achieving IOP reduction ≥20% compared to baseline	32 (76.2)	38 (90.5)	42 (100)	42 (100)	41 (97.6)	42 (100)	42 (100)
Proportion using ≥1 fewer medication compared to baseline	–	–	42 (100)	42 (100)	40 (95.2)	40 (95.2)	40 (95.2)
Proportion medication-free	–	–	39 (92.9)	40 (95.2)	36 (85.7)	38 (90.5)	36 (85.7)

Figure 2 Mean intraocular pressure (IOP) values over time for eyes with angle closure glaucoma undergoing goniosynechialysis and excisional goniotomy with the Kahook Dual Blade along with phacoemulsification (with SE bars).

Figure 3 Mean medication use over time for eyes with angle closure glaucoma undergoing goniosynechialysis and excisional goniotomy with the Kahook Dual Blade along with phacoemulsification (with SE bars).