Surgical outcomes of excisional goniotomy using the kahook dual blade in severe and refractory glaucoma: 12-month results

Bravetti, Giorgio Enrico; Gillmann, Kevin; Salinas, Lauriane; Berdahl, John P.; Lazcano‐Gomez, Gabriel; Williamson, Blake K.; Dorairaj, Syril; Seibold, Leonard K.; Smith, Sanjay; Aref, Ahmad A.; Darlington, Jason K.; Jiménez-Román, Jesús; Mahootchi, Ahad; Mansouri, Kaweh

doi:10.1038/s41433-022-02196-y

Cited by 5 publications

(2 citation statements)

References 33 publications

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“…Four eyes required a secondary glaucoma intervention within the first month 25 . Recent reports are generally consistent regarding the 12-month IOP achieved, medication reduction, and complications 26,27 …”

Section: Bypassing Trabecular Meshwork By Tissue Excision; Enhancing ...mentioning

confidence: 71%

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Minimally Invasive Glaucoma Surgery: Latest Developments and Future Challenges

Chan,

Larson,

Dickerson

et al. 2023

Asia-Pacific Journal of Ophthalmology

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The development of minimally invasive glaucoma surgeries (MIGSs) was intended to provide safe and modestly efficacious modalities for early intervention of mild-to-moderate glaucoma, with minimal trauma and rapid recovery. They were mainly ab interno procedures that reduce intraocular pressure by facilitating the aqueous outflow by bypassing the trabecular meshwork resistance, reinforcing the uveoscleral flow via the supraciliary space, and reducing aqueous production by the ciliary body. While the cumulating evidence helps shape the role of the available MIGS, the exponential new development and advancement in this field has expanded the territory of MIGS. Apart from developing subconjunctival MIGS filtration devices (Xen gel stent and PRESERFLO MicroShunt), there is a tendency to revisit the “traditional” MIGS for alternative use and to modify the procedures with consideration of the fundamental aqueous outflow physiology. Combined MIGS has also been suggested, based on the theory that their different mechanisms may provide additive or synergistic effects. The advancement of laser procedures is also promising and could supplement unmet needs along the glaucoma treatment algorithm. This review examines the broad array of MIGS, updates the recent findings, discusses their potential alternative applications, and explores future challenges.

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Section: Bypassing Trabecular Meshwork By Tissue Excision; Enhancing ...mentioning

confidence: 71%

“…25 Recent reports are generally consistent regarding the 12-month IOP achieved, medication reduction, and complications. 26,27 Tanito Microhook…”

Section: Kahook Dual Blade Goniotomymentioning

confidence: 99%

Minimally Invasive Glaucoma Surgery: Latest Developments and Future Challenges

Chan,

Larson,

Dickerson

et al. 2023

Asia-Pacific Journal of Ophthalmology

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Clinical Outcomes of Excisional Goniotomy with the Kahook Dual Blade: 6-Year Results

Vasu,

Abubaker,

Boopathiraj

et al. 2024

Ophthalmol Ther

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Introduction This study aims to evaluate the long-term clinical outcomes of excisional goniotomy with the Kahook Dual Blade (KDB) in the management of various types of glaucoma. Methods This was a retrospective, noncomparative chart review of 90 eyes of 53 patients with glaucoma that underwent standalone KDB goniotomy (KDB-alone group) or KDB goniotomy with concomitant phacoemulsification (KDB-phaco group) between October 2015 and October 2017. Surgical success was defined as an intraocular pressure (IOP) reduction by ≥ 20% at the last follow-up with no surgical reinterventions required and a final IOP ≥ 4 mmHg and ≤ 21 mmHg. We also report on changes from baseline in IOP, number of glaucoma medications, best-corrected visual acuity (BCVA), and visual field parameters, for up to 72 months. Results At 72 months, mean (standard deviation [SD]) IOP was reduced from 17.5 (5.7) to 13.6 (3.0) mmHg ( P < 0.0001) in the KDB-phaco group and from 23.3 (5.9) to 15.1 (6.2) mmHg ( P = 0.0593) in the KDB-alone group. The mean (SD) number of glaucoma medications was reduced from 1.3 (1.0) to 0.8 (0.9) ( P < 0.0001) in the KDB-phaco group and from 1.2 (1.0) to 0.7 (0.8) ( P = 0.3409) in the KDB-alone group. During the 72-month follow-up, surgical success was achieved in 24 of the 52 available eyes (46.2%). Four eyes underwent a glaucoma surgical reintervention by 72 months. Conclusions Excisional goniotomy with the KDB effectively lowered the IOP (by an average of 28.0% from baseline) and maintained or further reduced glaucoma medication burdens (by an average of 30.8% from baseline) under an excellent safety profile, independent of phacoemulsification status. The procedure exhibited favorable success for up to 6 years, providing valuable insights into its long-term efficacy as a glaucoma treatment. Supplementary Information The online version contains supplementary material available at 10.1007/s40123-024-01016-8.

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Gonioscopy-Assisted Transluminal Trabeculotomy Outcomes Under Different Levels of Glaucoma Severity: A Multicenter, Comparative Study

Magacho,

Franco,

et al. 2024

American Journal of Ophthalmology

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Surgical outcomes of excisional goniotomy using the kahook dual blade in severe and refractory glaucoma: 12-month results

Cited by 5 publications

References 33 publications

Minimally Invasive Glaucoma Surgery: Latest Developments and Future Challenges

Minimally Invasive Glaucoma Surgery: Latest Developments and Future Challenges

Clinical Outcomes of Excisional Goniotomy with the Kahook Dual Blade: 6-Year Results

Gonioscopy-Assisted Transluminal Trabeculotomy Outcomes Under Different Levels of Glaucoma Severity: A Multicenter, Comparative Study

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