Goniotomy with Kahook Dual Blade may be considered first as treatment in certain patients with glaucoma, according to a study.
In a retrospective case series, researchers reviewed the success of goniotomy using the Kahook Dual Blade (New World Medical) with trabecular meshwork excision in lowering the IOP of patients with uveitis-associated ocular hypertension or glaucoma refractory to medical therapy.
Sixteen eyes of 12 patients were studied, and patients were followed a minimum 5 months after surgery. The main outcomes included IOP after surgery, percentage of IOP reduction and reduction of glaucoma medications.
The mean maximum IOP before maximum-tolerated medical therapy or surgery was 35.6 mm Hg. The mean preoperative IOP in-office before surgery was 28.1 mm Hg when using the maximum-tolerated medical therapy.
Ten eyes were found to have maintained IOPs at or under goal levels through a median follow-up period of 9.6 months.
The mean number of glaucoma medications needed postoperatively was reduced from 3.6 to 2.1 (P = .004).
“All patients in our case series had an IOP reduction postoperatively, and many patients were able to reduce glaucoma medications, including oral carbonic anhydrase inhibitors,” the study authors said. “The results of this study are not surprising as they are consistent with [previous] studies that report the success of other angle-based procedures in patients with uveitis-associated [ocular hypertension] and glaucoma.” – by Earl Holland Jr.
Disclosures: Miller reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.