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Dual blade goniotomy and direct visco dilation of the collector channels combined with cataract surgery in eyes with previous laser peripheral iridotomies: 3 year follow up

Poster Details

First Author: J. Gilmore USA

Co Author(s):    L. Burk   L. Gilmore                 

Abstract Details


The purpose was to evaluate Dual Blade Goniotomy and Direct Viscodilation of the collector channels in eyes with previous peripheral iridotomies for narrow angle glaucoma. Could the モclean the gutter and power wash the downspoutヤ procedure effectively open the once aggravated trabecular meshwork?


This report is a retrospective study of narrow angle glaucoma patients who presented for cataract surgery in a private practice. All surgery was performed by one surgeon (L.L.B)


After standard cataract surgery, 32 eyes had 180 degrees of trabecular meshwork removed with the Kahook Dual Blade exposing the ostium of the collector channels allowing direct visco-dilation of the collector channels. Viscoelastic was injected into the collector channels as the cannula was snuggly held perpendicularly against the outer wall and dragged through the opened Schlemmメs canal. Viscoelastic was used to break any anterior synechiae. 53% were African American. 72% were women.The average age was 68 years. 41% had moderate or advanced glaucoma. 51% were diabetics. 28% were on anticoagulants.


Before surgery, the IOP was 22.4mmHG (SD+/- 7.7) on 1.4 drops. At 3 months, the IOP was 15.0mmHG (SD+/-4.1) on 0.3 eye drops. IOPs were 16.1mmHG (SD+/- 4.7) on 0.4 eye drops(1yr), 14.3mmHG (SD+/- 3.5) on 0.7 eye drops, and 14.7mmHG (SD +/-4.7) on 0.5 eye drops. Eye drops were eliminated in 74% (1yr), 53% (2yr), and 64% (3yr). A blush of blood was seen over the trabecular meshwork was common in the angle but was gone in two weeks. Avascular fibrosis was seen in several eyes and removed with the Dual Blade when the trabecular meshwork had been identified.


Narrow angles previously treated with laser iridotomies can be successfully treated with the Goniotomy-Visco-dilation-Cataract Surgery technique. This モclean the gutter and powerwash the downspoutsヤ approach demonstrates that the once aggravated trabecular meshwork can be rejuvenated, improving IOP control and reducing the amount of drops required.

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