Official ESCRS | European Society of Cataract & Refractive Surgeons


Goniotomy using the Kahook Dual Blade (KDB) in glaucoma: a 3-month follow-up of tonographic outflow facility

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Session Details

Session Title: Presented Poster Session: Glaucoma II

Venue: Poster Village: Pod 3

First Author: : A.Nagar UK

Co Author(s): :    S. Goyal   E. Galvis   A. Ramirez   A. Das   P. Alaghband   S. Lim        

Abstract Details


To describe the changes in intraocular pressure (IOP) and tonographic outflow facility following goniotomy with trabecular meshwork excision using the Kahook Dual Bade in patients with uncontrolled glaucoma and ocular hypertension


Prospective, interventional exploratory case series. St Thomas' Hospital, London


All pseudophakic patients with primary open angle glaucoma (POAG) or ocular hypertension (OHT) with uncontrolled IOP despite treatment were recruited from the glaucoma clinic and were offered KDB as treatment. Subtenon local  anaesthesia was used and a 100-120 degree excision was performed. Postoperative treatment included four weeks of topical corticosteroids. A 4-week washout of glaucoma medications was performed prior to the baseline and the 3 month postoperative aqueous dynamic measurement studies. Outcome measures: IOP (Goldmann tonometry) and Trabecular Outflow facility (TOF, Schiotz tonography)


22 patients were recruited onto the study with 18 completing a 3 month follow up. IOP reduction of 21.6% was achieved (p=0.02) at 3 months following surgery. There was a significant increase in outflow facility from 0.050 microl/min at baseline to 0.098 microl/min at three months on washout (96%, p=0.04). There were no surgical complications.


Kahook Dual Blade goniotomy shows a clinically and statistically significant reduction in intraocular pressure 3 months post operatively. There is a statistically significant increase in outflow facility which may associated with this reduction.

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