Back to Journals » Clinical Ophthalmology » Volume 13

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

Authors Dorairaj S, Tam MD, Balasubramani GK

Received 29 June 2019

Accepted for publication 28 August 2019

Published 10 September 2019 Volume 2019:13 Pages 1779—1785

DOI https://doi.org/10.2147/OPTH.S221299

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser


Syril Dorairaj,1 Mai Dang Tam,2 Goundappa K Balasubramani3

1Department of Ophthalmology, Mayo Clinic, Jacksonville, FL, USA; 2Glaucoma Department, Ho Chi Minh City Eye Hospital, Ho Chi Minh City, Vietnam; 3University of Pittsburgh, Department of Epidemiology, Pittsburgh, PA, USA

Correspondence: Syril Dorairaj
Department of Ophthalmology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA
Tel +1 201 704 7896
Email syrildorairajmd@gmail.com

Purpose: To characterize clinical outcomes following Kahook Dual Blade (KDB)-assisted goniosynechialysis and excisional goniotomy combined with phacoemulsification in eyes with angle-closure glaucoma and cataract.
Setting: Two clinical practices.
Methods: In this retrospective analysis of existing health records, data were collected from 42 eyes of 24 subjects from preoperative, operative, and postoperative encounters through 12 months of follow-up. Outcomes included changes in mean IOP, IOP-lowering medications, and logMAR best-corrected visual acuity (BCVA), as well as the proportions of patients achieving IOP reductions ≥20%, IOP ≤18 mmHg, and a reduction of ≥1 medication.
Results: Preoperative, mean (standard error) IOP was 25.5 (0.7) mmHg and at Month 12 was reduced by 12.3 (0.73) mmHg (−47.2%; p<0.0001). The mean number of IOP-lowering medications used was 2.3 (0.1) preoperatively and was reduced at Month 12 by 2.2 (0.12) (−91.7%; p<0.0001). At Month 12, 92.9% of eyes achieved IOP ≤18 mmHg, 100% achieved IOP reduction of ≥20%, 95.2% required ≥1 fewer medications for IOP control, and 85.7% (36/42) were medication-free. Mean LogMAR BCVA improved from 0.547 (0.06) at baseline to 0.159 (0.07) at Month 12.
Conclusion: KDB-assisted goniosynechialysis and excisional goniotomy at the time of phacoemulsification safely provide significant reductions in both IOP and IOP-lowering medication burden in eyes with angle-closure glaucoma, while simultaneously improving visual acuity.

Keywords: glaucoma, angle closure, synechialysis, goniotomy, MIGS
 

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]