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Goniotomy With Kahook Blade in Cataract Surgery Effective

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Researchers led by Halward Blegen IV, of Brooke Army Medical Center, assessed the efficacy of Kahook Dual Blade (KDB) goniotomy combined with cataract extraction vs cataract extraction alone, in patients with open-angle glaucoma (OAG), for their IOP-lowering effect and reduction in medications. The researchers conducted a retrospective study of adults older than 18 who were treated for OAG and underwent either cataract removal via phaco or combined cataract extraction with KDB goniotomy. Inclusion criteria required one of the above procedures and 18 months of follow-up. Exclusion criteria included history of prior intraocular surgery or acute angle closure, chronic topical steroid use, and lack of follow-up for at least 18 months. Clinical data sought were preoperative and postoperative IOP and number of IOP-lowering medications used.

Average preoperative IOP was 18.1 mmHg (KDB) vs 16.0 (phaco). Average postoperative IOP, after 12 months, was 14.80 (KDB) vs 14.85 (phaco). KDB caused an 18.2% IOP reduction vs 7.2% for phaco alone). At 18 months postoperative, there was a -1.2 change in number of IOP medications used for KDB vs. +0.29 in phaco alone (P<.0001). The researchers concluded that KDB goniotomy plus phaco results in a greater reduction in IOP and medications vs cataract extraction alone in patients with OAG. The researches stated in their presentation of results at the 2020 ASCRS Virtual Annual Meeting that these finding should be included in discussions of surgical options for patients with both OAG and visually significant cataract.