Kahook Goniotomy

There are many treatments for glaucoma, but there is no cure. Treatments for glaucoma all aim to lower pressure in the eye to decrease the risk of progressive damage to the optic nerve and vision loss. 

For patients who are planning on cataract surgery, we may recommend that a glaucoma mini-procedure be done at the same time. MIGS is an abbreviation for Minimally Invasive Glaucoma Surgery. There are several types of MIGS procedures that are FDA approved and commonly used at the time of cataract removal. We most commonly use the Kahook goniotomy which is a type of MIGS. In this procedure, the surgeon unroofs a tiny portion of the drainage system inside the eye. This often increases drainage of fluid that builds up on the inside of the eye, thereby lowering eye pressure.

MIGS procedures such as the Kahook goniotomy are fast and generally low-risk. The Kahook goniotomy typically adds less than 5 minutes to cataract surgery time. The disadvantage of this procedure is that its success rate of lowering eye pressure is only about 50 to 70%. This means that 30-50% of the time the procedure does not lower eye pressure. 

Nonetheless, as the Kahook goniotomy is quick, very low risk, does not generally add to recovery time, and the patient is already in the operating room, we offer this procedure to many of our glaucoma patients who are undergoing cataract surgery.  If effective, the eye pressure may be lowered by several points– not usually enough to stop glaucoma medications if the patient is already on them, but the patient is less likely to need additional treatment for glaucoma in the near future if the pressure is lowered. Also, any lowering of pressure is safer for an optic nerve in a glaucomatous eye. The pressure lowering effect can take several weeks to be apparent.

There is a small risk of bleeding at the time of the procedure, but this blood is resorbed by the eye and generally not a significant issue.

If you have questions, please call our office at 847-497-2020 or message us via the Endeavor message system (formerly NorthShore Connect).