Dual Blade goniotomy and direct viscodilation of the collector channels combined with cataract surgery: one-year results

Session Details

Session Title: Combined Cataract Surgery & Practice Styles

Session Date/Time: Sunday 15/09/2019 | 14:00-16:00

Paper Time: 14:12

Venue: Free Paper Forum: Podium 2

First Author: : L.Burk USA

Co Author(s): :    J. Gilmore   L. Gilmore                          

Abstract Details

Purpose:

Combined Kahook Dual Blade Goniotomy and Direct Viscodilation of the Collector Channels with cataract surgery technique was evaluated for its effect on IOP and dependence on glaucoma drops in all levels of glaucoma. The “clean the gutter and power wash the downspouts” technique not only removes trabecular meshwork but forcibly viscodilates the collector channels.

Setting:

This report is a retrospective study of glaucoma patients who presented for cataract surgery in a private practice. All surgery was performed by one surgeon (L.L.B.)

Methods:

After standard cataract surgery, 180 degrees of trabecular meshwork were removed with the Kahook Dual Blade exposing the ostium for Direct Visco-Dilation of the collector channels. IOP was monitored every 3 months and treated with glaucoma medications as needed. Moderate to severe glaucoma comprised half of the 120 eyes seen for one year. 33% had previous glaucoma surgery. 53% were diabetics. 80% were African-American. 50% were on anticoagulants.

Results:

Initial IOP was 18.8 mmHG (SD+/-5.4) on 1.7 eye drops. At three months the IOP was 15.8 mmHG (SD+/- 4.7). Throughout the first year the IOP fluctuated around 16.5 mmHG and continued to 16.2mmHg (SD+/- 3.9) in 70 eyes at 18 months.The average reduction in eye drops was 1.5 drops per eye. Although IOP was reduced only 15% in this group, drops were stopped in 90% of eyes and 91% of all drops previously prescribed were eliminated. In just these 120 eyes, 200 bottles of drops were stopped per month, the equivalent of 2400 bottles in one year.

Conclusions:

The synergy of Goniotomy and Direct Visco Dilation of the collector channels markedly reduces the intraocular pressure and medications in all levels of glaucoma. This combination of two MIGS procedures is a safe and effective approach for compliance issues and the financial burden associated with glaucoma management.

Financial Disclosure:

None