Six months' follow-up of combined phacoemulsification-kahook dual blade excisional goniotomy

Nicole Mechleb, Karim Tomey, Daniel Cherfan, Antony Nemr, Georges Cherfan, Syril Dorairaj, Ziad Khoueir

Research output: Contribution to journalArticlepeer-review


PURPOSE: This study reports on the combination of excisional goniotomy and cataract extraction in the management of glaucoma in terms of intraocular pressure (IOP) and glaucoma medication reduction. METHODS: This is a retrospective case series. Twenty-eight eyes of 22 patients with the diagnosis of cataract and ocular hypertension or glaucoma of any stage underwent combined phacoemulsification and Kahook Dual Blade (KDB) goniotomy, between March 2019 and September 2020. The parameters evaluated were postoperative best-corrected visual acuity, mean IOP reduction, number of IOP-lowering medications, and the surgical success rate defined as IOP reduction >20% and/or reduction in glaucoma medications >1. RESULTS: The mean IOP reduction at 6 months was 4.5 mmHg (P = 0.0007), which translates to 24.9% reduction from preoperative IOP. The mean preoperative number of glaucoma medications was 2.9 ± 1.0 (median of 3). It was reduced to 1.1 ± 1.1 (median of 1.5), 1.46 ± 1.17 (median of 2), 1.44 ± 1.28 (median of 2), and 1.56 ± 1.28 (median of 2) at 1 week, 1 month, 3 months, and 6 months, respectively. Twenty-nine percent (8/28) of the patients were off glaucoma medications at 6 months and 46% (13/28) had a reduction of more than 50% of their glaucoma medications. CONCLUSION: Combined phacoemulsification-KDB excisional goniotomy may be an effective and safe alternative to more invasive filtering surgery in glaucoma patients of any stage.

Original languageEnglish (US)
Pages (from-to)195-200
Number of pages6
JournalSaudi Journal of Ophthalmology
Issue number2
StatePublished - Apr 1 2022


  • Glaucoma
  • goniotomy
  • Kahook Dual Blade
  • phacoemulsification

ASJC Scopus subject areas

  • Ophthalmology


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