12-Month Outcomes of Goniotomy Performed Using the Kahook Dual Blade Combined with Cataract Surgery in Eyes with Medically Treated Glaucoma

Syril Dorairaj, Leonard K. Seibold, Nathan M. Radcliffe, Ahmad A. Aref, Jesús Jimenez-Román, Gabriel S. Lazcano-Gomez, Jason K. Darlington, Kaweh Mansouri, John P. Berdahl

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

Introduction: To describe the 12-month efficacy and safety of goniotomy performed using the Kahook Dual Blade (KDB) in combination with cataract surgery in eyes with medically treated open-angle glaucoma (OAG). Methods: This was a prospective, interventional case series conducted at seven centers in North America. Consecutive patients with medically treated OAG and visually significant cataract underwent phacoemulsification combined with goniotomy (PE + goniotomy) using KDB. Indications for glaucoma surgery included reduction of intraocular pressure (IOP) and reduction of IOP-lowering medications. De-identified data were collected and included pre-, intra-, and postoperative data on IOP, the use of IOP-lowering medications, and adverse events through 12 months of follow-up. Results: Among 52 eyes undergoing surgery, mean IOP was reduced from 16.8 ± 0.6 mmHg at baseline to 12.4 ± 0.3 mmHg at month 12 (P < 0.001), a 26.2% reduction. Mean IOP across time points ranged from 12.4–13.3 mmHg during follow-up. The mean number of topical IOP-lowering medications was reduced from 1.6 ± 0.2 at baseline to 0.8 ± 0.1 at month 12 (P < 0.05), a 50.0% reduction. At month 12, 57.7% of eyes had IOP reduction ≥ 20% from baseline, and 63.5% were on ≥ 1 fewer IOP-lowering medications. In subgroup analysis, 84.6% of eyes with lower mean baseline IOP were using ≥ 1 fewer medications at month 12, and 100% of eyes with higher mean baseline IOP had IOP reductions ≥ 20%. The most common postoperative adverse events were pain/irritation (n = 4, 7.7%), opacification of the posterior lens capsule (n = 2, 3.8%), and IOP spike > 10 mmHg (n = 2, 3.8%). Conclusion: PE + goniotomy using the KDB significantly lowers both IOP and dependence on IOP-lowering medications in eyes with OAG. Adverse events were not sight-threatening and typically resolved spontaneously. Funding: New World Medical, Inc.

Original languageEnglish (US)
Pages (from-to)1460-1469
Number of pages10
JournalAdvances in Therapy
Volume35
Issue number9
DOIs
StatePublished - Sep 1 2018

Keywords

  • Cataract surgery
  • Glaucoma
  • Goniotomy
  • Intraocular pressure
  • Micro-incisional glaucoma surgery
  • Micro-invasive glaucoma surgery
  • Ophthalmology
  • Phacoemulsification
  • Trabecular meshwork

ASJC Scopus subject areas

  • Pharmacology (medical)

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    Dorairaj, S., Seibold, L. K., Radcliffe, N. M., Aref, A. A., Jimenez-Román, J., Lazcano-Gomez, G. S., Darlington, J. K., Mansouri, K., & Berdahl, J. P. (2018). 12-Month Outcomes of Goniotomy Performed Using the Kahook Dual Blade Combined with Cataract Surgery in Eyes with Medically Treated Glaucoma. Advances in Therapy, 35(9), 1460-1469. https://doi.org/10.1007/s12325-018-0755-4