Ab Interno Goniotomy With A Kahook Dual Blade In 2-Year Follow-Up

To evaluate the efficacy and safety of ab interno goniotomy using a Kahook Dual Blade in combination with cataract phacoemulsification in patients with primary open angle glaucoma in a 2-year follow-up.

Division of Ophthalmology and Optometry, Department of Ophthalmology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland

This retrospective, interventional case series comprised 75 eyes which underwent ab interno goniotomy and cataract phacoemulsification with an in-the-bag IOL implantation. All surgeries were performed by the same surgeon with a single-use Kahook Dual Blade. Schlemm’s canal was opened over 100-120°. Mean pre- and postoperative intraocular pressure, the number of glaucoma medications, complications of the surgery and the need for another procedure were analyzed in a 2-year follow-up.

Mean intraocular pressure (IOP) before the surgery was 21.9±3.9 mmHg and mean number of glaucoma medications was 2.2±1.1. A reduction in intraocular pressure of 17.1% and a 57 % decrease (p<0.001) in the number of glaucoma medications were noted. Some intraoperative bleeding was observed in all cases. On the first days after the surgery, there were blood cells or a transient hyphema in 38% of the eyes. In 6 eyes an IOP rise over 25 mmHg was observed in early postoperative period. In one eye there was no postoperative intraocular pressure stabilization and laser cyclodestruction was performed.

Ab interno goniotomy performed simultaneously with phacoemulsification results in a significant reduction in intraocular pressure and a decrease in the number of glaucoma medications used. The treatment is characterized by a good safety profile and does not require intensive postoperative management.