Goniotomy is a minimally invasive procedure where your surgeon uses a device such as the Kahook Dual Blade (KDB) or SION to help open up the internal drainage system (or trabecular meshwork of the eye). The KDB and SION are both single-use ophthalmic blade with a micro-engineered profile allowing for insertion into the eye through a clear cornea micro-incision. Goniotomy can be done with or without cataract surgery, and when done in conjunction with cataract surgery it is done following lens removal through the same incision utilized for the cataract removal.
The device is made of surgical grade stainless steel body with a long, thin shaft that allows for access across the anterior chamber to the trabecular meshwork (TM). Using a special mirrored lens, the surgeon uses the KDB or SION to make parallel incisions in the trabecular meshwork (TM), un-roofing it and opening up into inner wall of the Canal of Schlemm to improve aqueous humor outflow from the eye in an effort to reduce the eye pressure (a goniotomy).
This procedure does not involve opening up the conjunctival tissues; this is a major advantage of this procedure as it makes future glaucoma surgery (if needed) a lot simpler with less risk of failure.
This is an outpatient procedure performed in an ambulatory surgery center. The surgery is usually done under local anesthesia with intravenous sedation.
Your doctor will want to examine you in the office the following day and you will be prescribed a regimen of postoperative drops for the next four to six weeks.
If the procedure is successful you can expect a decrease in the intraocular pressure and you possibly may come off some of your glaucoma medications. It takes about 6 to 8 weeks before the outcome of the procedure is known.