Goniotomy Outcomes for Kahook Dual Blade and TrabEx Blades

Abstract

Purpose : Both Kahook Dual Blade (KDB) and TrabEx blades are used for goniotomy surgeries. This study describes surgical outcomes for both KDB and TrabEx goniotomies.

Methods : This is an IRB-approved retrospective chart review for a multi-surgeon, large academic center using the CPT code 65820 for goniotomy from January 2012 to May 2022. Charts were individually reviewed and KDB and TrabEx surgeries were included in the analysis; all surgeries were combined cataract and goniotomy surgeries. Intraocular pressure (IOP) and number of drops were recorded at various time points after surgeries for both KDB and TrabEx surgeries.

Results : A total of 600 eyes were included, of which 557 underwent combined cataract surgery and KDB goniotomy and 43 underwent combined cataract and TrabEx surgery. Baseline IOP was 17.2 ± 5.3 mmHg for the KDB group and 15.8 ± 4.4 mmHg for the TrabEx group (p = 0.06). Mean IOP at 3 months after surgery was 14.7 ± 3.7 mmHg for the KDB group and 12.4 ± 2.9 mmHg for the TrabEx group (p<0.01). Mean IOP at 6 months after surgery was 14.8 ± 3.8 mmHg for the KDB group and 13.3 ± 4.3 mmHg for the TrabEX group (p=0.09). Mean IOP at 1 year after surgery was 14.9 ± 4.5 mmHg for the KDB group and 14.3 ± 4.3 mmHg for the TrabEx group (p=0.48). Mean IOP at 2 years after surgery was 14.7 ± 3.7 mmHg for the KDB group and 14.5 ± 3.6 mmHg for the TrabEx group (p=0.88). Mean number of medications at 2 years after surgery was 1.9 ± 1.4 drops for the KDB group and 1.5 ± 1.0 drops for the TrabEx group (p=0.46).

Conclusions : Both KDB and TrabEx are effective procedures at lowering IOP. There may be a trend of greater IOP reduction in the early post-operative period for TrabEx surgeries, but randomized controlled trials are required to investigate this further.

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