Ab-interno trabeculotomy with Kahook dual blade in secondary traumatic glaucoma in a child

Laura Silva Reis; Ana Elisa Loyola Arancibia; Tiago Santos Prata; Fabio Nishimura Kanadani

doi:10.1016/j.ajoc.2022.101354

Ab-interno trabeculotomy with Kahook dual blade in secondary traumatic glaucoma in a child

Am J Ophthalmol Case Rep. 2022 Jan 26:25:101354. doi: 10.1016/j.ajoc.2022.101354. eCollection 2022 Mar.

Authors

Laura Silva Reis¹, Ana Elisa Loyola Arancibia¹, Tiago Santos Prata^{2

3

4}, Fabio Nishimura Kanadani^{1

4}

Affiliations

¹ Department of Ophthalmology, Glaucoma Institute of Belo Horizonte, Brazil.
² Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil.
³ Glaucoma Unit, Hospital Medicina dos Olhos, São Paulo, Brazil.
⁴ Department of Ophthalmology, Mayo Clinic, Jacksonville, FL, USA.

Abstract

Purpose: To report a successful ab-interno trabeculotomy with Kahook Dual Blade (KDB) in secondary traumatic angle recession glaucoma in a child and discuss the possible mechanisms of action.

Observations: A 7 years-old boy presented, after a blunt trauma in the left eye, with angular recess surroundings 110° and concomitant intra-ocular pressure (IOP) elevation around 35 mmHg, despite the maximum topical and systemic ocular hypotensive therapy. As there was no glaucomatous neuropathy yet, a KDB ab-interno trabeculotomy was performed. After KDB's surgery, oral and topical hypotensive medications were gradually withdrawn until complete suspension with IOP levels around 11 mmHg, which has remained the same in the last 2 years. Both functional and structural assessment of glaucoma have maintained stable throughout the follow-up until the present moment.

Conclusion and importance: The KDB has demonstrating a favorable safety profile and a useful surgical technique that should be considered mainly in trabecular glaucomas, as well as those secondary to trauma. Studies are still needed to define which patient and glaucoma profile are the most suitable for the procedure and for how long it is effective.

Keywords: Ab-interno trabeculotomy; Children; Traumatic glaucoma.

Publication types

Case Reports