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Kahook Dual Blade Excisional Goniotomy and Goniosynechialysis Combined With Phacoemulsification for Angle-closure Glaucoma

6-Month Results

Dorairaj, Syril MBBS, MD*; Tam, Mai Dang MD

doi: 10.1097/IJG.0000000000001256
Case Report/Small Case Series

Purpose: The purpose of this study was to characterize reductions in intraocular pressure (IOP) and the need for IOP-lowering medications following phacoemulsification combined with Kahook Dual Blade-assisted goniosynechialysis and excisional goniotomy in eyes with angle-closure glaucoma and cataract.

Methods: In this retrospective, interventional case series, preoperative, operative, and postoperative data were collected through 6 months of follow-up from 42 eyes of 24 subjects. Outcomes included mean IOP reduction, reduction in IOP-lowering medications, and the proportion of patients achieving IOP reduction ≥20%, IOP≤18 mm Hg, and reduction of ≥1 medication.

Results: Preoperatively, mean (SE) IOP was 25.5 (0.7) mm Hg and the mean number of IOP-lowering medications used was 2.3 (0.1) per eye. Through 6 months of follow-up, mean IOP reductions of 10.1 to 12.8 mm Hg (38.4% to 49.5%; P<0.0001) and mean IOP medication reductions of −2.2 to −2.3 (91.7% to 98.4%; P<0.0001) were seen. At month 6, 92.9% of eyes (39/42) achieved IOP≤18 mm Hg, 100% (42/42) achieved IOP reduction of ≥20%, 100% (42/42) required ≥1 fewer medications for IOP control, and 85.7% (36/42) were medication free.

Conclusions: Phacoemulsification combined with Kahook Dual Blade-assisted goniosynechialysis and excisional goniotomy safely provides statistically and clinically meaningful reductions in both IOP and the need for IOP-lowering medications in eyes with angle-closure glaucoma.

*Department of Ophthalmology, Mayo Clinic, Jacksonville, FL

Glaucoma Department, Ho Chi Minh City Eye Hospital, Ho Chi Minh City, Vietnam

Disclosure: S.D. is a consultant for New World Medical but did not receive any funding support for the conduct of this study. M.D.T. declares no conflict of interest.

Reprints: Syril Dorairaj, MBBS, MD, 4500 San Pablo Road, Mayo Clinic, Jacksonville, FL 32224 (e-mail:

Received February 7, 2019

Accepted March 24, 2019

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