To view enhanced digital features for this article go to https://doi.org/10.6084/m9.figshare.7145831.
To characterize the reduction in intraocular pressure (IOP) and IOP-lowering medication use following goniotomy via trabecular meshwork excision performed using the Kahook Dual Blade as a stand-alone procedure in adult eyes with glaucoma uncontrolled on a regimen of 1–3 topical IOP-lowering medications.
In this retrospective analysis, data from consecutive patients undergoing goniotomy with the Kahook Dual Blade by 11 surgeons were analyzed. Preoperative, intraoperative, and postoperative follow-up data through 6 months of follow-up were collected. The primary efficacy endpoint was IOP reduction from preoperative baseline; reduction in IOP-lowering medication use was a secondary endpoint.
Data were collected from 53 eyes of 42 subjects. Mean (± SE) preoperative IOP was 23.5 ± 1.1 mmHg, and from day 1 through 6 months of postoperative follow-up mean IOP reductions of 7.0–10.3 mmHg (29.8–43.8%; p < 0.001 at each time point) were observed. Mean preoperative medication use was 2.5 ± 0.2 medications per eye and was reduced by month 6 to 1.5 ± 0.2 (a 40.0% reduction; p < 0.05). Eyes with higher baseline IOP experienced mean IOP reductions of 13.7 mmHg (− 46.4%) at month 6, while eyes with lower baseline IOP experienced mean IOP reductions of 3.8 mmHg (− 21.0%) at month 6. Mean medications were reduced by 1.3 medications in high-IOP eyes and by 0.9 in low-IOP eyes at month 6. No significant sight-threatening adverse events were observed.
Goniotomy via trabecular meshwork excision performed using the Kahook Dual Blade effectively and safely lowered IOP when performed as a stand-alone procedure in eyes with glaucoma. The significant drop in IOP met or exceeded the recommended targets for these glaucoma patients.
New World Medical, Inc.
Johnson M. What controls aqueous humour outflow resistance? Exp Eye Res. 2006;82:545–57. CrossRef
Cairns JE. Trabeculectomy. Preliminary report of a new method. Am J Ophthalmol. 1968;66:673–9. CrossRef
Chaudhry HA, Dueker DK, Simmons RJ, Bellows AR, Grant WM. Scanning electron microscopy of trabeculectomy specimens in open-angle glaucoma. Am J Ophthalmol. 1979;88:78–92. CrossRef
Zahid S, Musch DC, Niziol LM, Lichter PR, Collaborative Initial Glaucoma Treatment Study Group. Risk of endophthalmitis and other long-term complications of trabeculectomy in the Collaborative Initial Glaucoma Treatment Study (CIGTS). Am J Ophthalmol. 2013;155:674–680, 80 e1. CrossRef
Greenwood MD, Seibold LK, Radcliffe N, et al. Goniotomy with the Kahook Dual Blade: short term results of an interventional case series. J Cataract Refract Surg. 2017;43:1197–201. CrossRef
Heijl A, Leske MC, Bengtsson B, Hyman L, Bengtsson B, Hussein M. Reduction of intraocular pressure and glaucoma progression: results from the Early Manifest Glaucoma Trial. Arch Ophthalmol. 2002;120:1268–79. CrossRef
AGIS Study Group. The Advanced Glaucoma Intervention Study (AGIS): 4. Comparison of treatment outcomes within race. Seven-year results. Ophthalmology. 1998;105:1146–64. CrossRef
Lichter PR, Musch DC, Gillespie BW, et al. Interim clinical outcomes in the Collaborative Initial Glaucoma Treatment Study comparing initial treatment randomized to medications or surgery. Ophthalmology. 2001;108:1943–53. CrossRef
Collaborative Normal-Tension Glaucoma Study Group. Comparison of glaucomatous progression between untreated patients with normal-tension glaucoma and patients with therapeutically reduced intraocular pressures. Am J Ophthalmol. 1998;126:487–97. CrossRef
American Academy of Ophthalmology. Primary open-angle glaucoma: preferred practice pattern. San Francisco: American Academy of Ophthalmology; 2015.
European Glaucoma Society. Terminology and guidelines for glaucoma. 4th ed. Savona: PubliComm; 2014.
Chauhan BC, Mikelberg FS, Artes PH, et al. Canadian Glaucoma Study: 3. Impact of risk factors and intraocular pressure reduction on the rates of visual field change. Arch Ophthalmol. 2010;128:1249–55. CrossRef
Salinas L, Chaudhary A, Berdahl JP, et al. Goniotomy using the Kahook Dual Blade in severe and refractory glaucoma: six month outcomes. J Glaucoma. 2018. https://doi.org/10.1097/IJG.0000000000001019. CrossRefPubMed
Garcia-Feijoo J, Rau M, Grisanti S, et al. Supraciliary micro-stent implantation for open-angle glaucoma failing topical therapy: 1-year results of a multicenter study. Am J Ophthalmol. 2015;159(1075–81):e1.
Alcon announces voluntary global market withdrawal of CyPass Micro-Stent for surgical glaucoma. https://www.novartis.com/news/media-releases/alcon-announces-voluntary-global-market-withdrawal-cypass-micro-stent-surgical-glaucoma. Accessed Aug 29, 2018.
Ferguson TJ, Berdahl JP, Schweitzer JA, Sudhagoni R. Evaluation of a trabecular micro-bypass stent in pseudophakic patients with open-angle glaucoma. J Glaucoma. 2016;25:896–900. CrossRef
Armstrong JJ, Wasiuta T, Kiatos E, Malvankar-Mehta M, Hutnik CM. The effects of phacoemulsification on intraocular pressure and topical medication use in patients with glaucoma: a systematic review and meta-analysis of 3-year data. J Glaucoma. 2017;26:511–22. CrossRef
- Six-Month Outcomes of Goniotomy Performed with the Kahook Dual Blade as a Stand-Alone Glaucoma Procedure
John P. Berdahl
Mark J. Gallardo
Mohammed K. ElMallah
Blake K. Williamson
Malik Y. Kahook
Leonard A. Rappaport
Gabriel S. Lazcano-Gomez
Syril K. Dorairaj
- Springer Healthcare
Advances in Therapy
Print ISSN: 0741-238X
Elektronische ISSN: 1865-8652
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
e.Med Kampagnen-Visual, Mail Icon II