Goniotomy: A Glaucoma Treatment Alternative

Glaucoma treatment is constantly evolving. It’s a complex condition with no one-size-fits-all procedure and/or medication that works in every case. A surgical procedure, called a goniotomy, is becoming a popular alternative for addressing adult glaucoma.  

The reasons for this are many. To understand where and why goniotomy surgery might be an option, it’s necessary to have a basic understanding of the operation.

All About Goniotomy Surgery

• What is goniotomy surgery?
• Indications for performing goniotomy surgery
• Pros and cons of goniotomy surgery 

What is goniotomy surgery?

Goniotomy surgery lowers the pressure within the eye by cutting through a layer of the eye’s drainage system—the trabecular network. The surgeon removes a portion of the tissue that’s blocking the intra-eye fluid from draining correctly, leaving an open canal that creates a better flow. 

You might hear a goniotomy surgical procedure being described as:

• Kahook Dual Blade goniotomy (KDB)

or

• Gonioscopy-Assisted Transluminal-Trabeculotomy (GATT)

Both are types of minimally invasive glaucoma surgery (MIGS). As the name suggests, the procedure has fewer risks than other options, like a trabeculectomy or tube shunt. The lowering of eye pressure usually happens pretty quickly after the procedure is performed. A reduction of intra-eye pressure by as little as 20% usually means that the patient will be able to reduce or stop relying on one or more glaucoma drops. Realistically, a drop of 20%-30% is the expected outcome.

Indications for performing goniotomy surgery

Goniotomy surgery isn’t for everyone. Indications that it might be suitable include:

• Having moderate or severe open-angle glaucoma.
• Eye drops and medications don’t work or have stopped working.
• Laser treatment isn’t deemed suitable or hasn’t had the desired effect.
• The patient doesn’t need a full-blown excision of the eye’s drainage network (a trabeculectomy or tube shunt).

The procedure can also be performed in conjunction with cataract surgery. Another good thing about the surgery is that if it doesn’t work or effectiveness wanes over time, other operations (tube shunt, trabeculectomy, etc.) can be carried out at a later date.

There are a few contraindications to goniotomy surgery, such as thyroid eye disease. Your ophthalmologist will advise whether or not you might be suitable for the operation.

Pros and cons of goniotomy surgery

The biggest advantages of goniotomy surgery are that it’s fast to perform, minimally invasive, and tends to bring quick results. There is evidence that the lowering of intra-eye pressure following a procedure is relatively short-lived—perhaps as short as a year. However, if medications and other surgical options, such as a canaloplasty, aren’t effective, then a goniotomy can hold off the need for a more invasive procedure that causes more damage to the trabecular network.

Goniotomy has only recently returned to the fore as an adult treatment. The basic procedure came about in the 1970s and has since been a primary choice for child glaucoma. Recent advances in technology have seen the reemergence of the surgery for adults.

Whether or not the procedure is right for a patient depends on many different factors. As already stated, there’s no single treatment that works for everyone. But this cutting-edge operation provides another level of care for those who suffer—and that is definitely a great leap forward for surgeons and patients alike.

Is Goniotomy Surgery Right For You? Get World-Beating Glaucoma Treatment at the WBEC 

At the West Boca Eye Center, we follow a step-wise approach to treating glaucoma. If drug therapy begins to have a reduced effectiveness (or doesn’t work from the outset), our globally renowned ophthalmologists have a wide armory of other options. This includes the latest goniotomy surgery, alongside a suite of other dropless glaucoma therapies.

Discover more at https://www.westbocaeyecenter.com/services/glaucoma-dropless-therapy and call today to book an expert consultation.

Glaucoma treatment is constantly evolving. It’s a complex condition with no one-size-fits-all procedure and/or medication that works in every case.

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