Aim of the study

Evaluation of ab interno goniotomy using a Kahook Dual Blade in combination with phacoemulsification in patients with primary open angle glaucoma during a 6-month follow-up.

Material and methods

75 patients with mild and moderately advanced primary open angle glaucoma, who had phacoemulsification combined with ab interno goniotomy using a Kahook Dual Blade (New World Medical, USA), were included in this analysis. The average age was 68.4 ±8.9 years. Mean pre- and postoperative intraocular pressure, number of antiglaucoma medications, complications of the surgery and need for another procedure were analysed in the 6-month follow-up.

Results

Before the surgery, mean intraocular pressure was 21.9 ±3.9 mmHg and the number of antiglaucoma medications was 2.2 ±1.2. A reduction in intraocular pressure of 17.53% and a decrease in number of antiglaucoma medications of 60% (p < 0.001) were observed in the 6-month follow-up. There was slight intra-operative bleeding into the anterior chamber from the incision in all cases. On the first days after surgery there were diffuse blood cells or a clot in the anterior chamber in 38% of eyes. Increase in intraocular pressure above 25 mmHg on the first day after surgery was observed in 30.6% of eyes. In one eye there was no postoperative intraocular pressure stabilisation and laser cyclodestruction was performed.

Conclusions

Ab interno goniotomy performed simultaneously with phacoemulsification results in a significant reduction in intraocular pressure and a decrease in the number of anti-glaucoma drugs used. The treatment is characterized by a good safety profile and does not require intensive postoperative management.