36-Month Outcomes of Combined Phacoemulsification and Kahook Dual Blade Goniotomy

Abstract

Purpose : To evaluate 36-month safety and efficacy outcomes of concurrent phacoemulsification and excisional goniotomy with the Kahook Dual Blade (KDB) in the treatment of mild- to moderate-stage primary open angle glaucoma (POAG).

Methods : Forty-one eyes with POAG receiving KDB goniotomy and concomitant phacoemulsification were included. Primary outcomes included changes from baseline in intraocular pressure (IOP) and number of antiglaucoma medications (AGMs) at 1, 3, 6, 9, 12, 24, and 36 months, analyzed with paired sample t-tests. Secondary outcomes included the percentage of eyes achieving reduction in AGM burden by > 1 medication and/or > 20% IOP reduction from baseline at 36 months.

Results : At 36 months, the mean IOP was lowered from 20.5 + 3.5 mmHg to 13.5 + 2.2 mmHg (34% reduction; p<0.0001) and the mean number of AGMs was reduced from 1.3 + 0.7 to 0.1 + 0.4 (89% reduction; p<0.0001). When compared to baseline, 98% of eyes experienced reduction by > 1 AGM and 71% of eyes achieved > 20% IOP reduction. No vision-threatening complications or adverse effects were observed in any eye.

Conclusions : Excisional KDB goniotomy combined with phacoemulsification significantly reduced IOP and lowered glaucoma medication dependence in eyes with POAG. Overall, this combined procedure appears to be highly safe and effective in the treatment of POAG, through 36 months.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.