Treatment

Kahook Dual Blade Goniotomy

Also known as Kahook Goniotomy, Dual Blade Goniotomy, Excisional Goniotomy, Trabecular Meshwork Goniotomy, Minimally Invasive Glaucoma Surgery

Updated May 16, 2026For educational purposes only. Not a substitute for medical advice. See our terms.

Bottom Line

Kahook Dual Blade goniotomy is a small-incision glaucoma procedure that opens the eye's natural drain. It can lower eye pressure and reduce the need for drops in selected patients.

Kahook Dual Blade goniotomy removes a strip of trabecular meshwork. This tissue sits in the eye's drain, where fluid leaves the front of the eye. Removing that strip helps fluid leave more easily and can lower eye pressure 1.

The procedure is often done with cataract surgery. It can also be done alone in some eyes. It is usually used for open-angle glaucoma or ocular hypertension when drops or laser are not enough 2.

Kahook Dual Blade goniotomy lowers pressure less than trabeculectomy or tube shunt surgery. It also has a faster recovery and fewer serious risks for many patients 3.

How It Works

The eye makes clear fluid all day. That fluid leaves through the eye's drain, where fluid exits the front of the eye. The trabecular meshwork is the sieve-like tissue in that drain.

In Kahook Dual Blade goniotomy, the surgeon uses a small blade to remove a narrow strip of trabecular meshwork. This opens a direct path into the eye's outflow channel. The goal is to lower eye pressure without making an outside drainage pocket 1.

Who It Helps

Kahook goniotomy is most often considered when:

  • You have open-angle glaucoma or ocular hypertension.
  • Glaucoma is mild or moderate.
  • You are already planning cataract surgery.
  • Drops cause side effects, cost issues, or missed doses.
  • Your doctor wants moderate pressure lowering with a fast recovery.

It may not be enough if the optic nerve needs very low pressure. Those eyes may need trabeculectomy or tube shunt surgery instead.

Risks and Side Effects

Most side effects are short-lived, but every eye surgery has risk.

  • Blood in the front of the eye. This is common and usually clears.
  • Pressure spike. Eye pressure can rise early after surgery.
  • Inflammation. Steroid drops are often used during healing.
  • Blurred vision. Vision can fluctuate while blood and inflammation clear.
  • Not enough pressure lowering. Some eyes still need drops or more surgery.

Systematic reviews compare Kahook goniotomy with other angle surgeries and find a generally favorable safety profile 3.

Cost and Insurance

Kahook goniotomy is usually billed as glaucoma surgery. If it is done with cataract surgery, the surgery center may bill both procedures.

  • Medicare and many private plans cover it when the diagnosis and severity fit.
  • You may owe deductible, copay, or coinsurance.
  • Costs vary by surgeon, facility, anesthesia, and whether cataract surgery is combined.
  • Ask for a written estimate before surgery.

Ask the office to confirm coverage for the goniotomy code, the facility fee, and any cataract surgery charges.

Common Questions About Kahook Dual Blade Goniotomy

No. It lowers eye pressure, but glaucoma still needs lifelong monitoring.

Next Steps

  1. 1Book a glaucoma surgery consultation if drops or laser are not controlling pressure well enough.
  2. 2Ask whether your angle anatomy is open enough for Kahook goniotomy.
  3. 3Discuss whether cataract surgery should be combined with the procedure.
  4. 4Bring a list of all glaucoma drops and side effects to the visit.
  5. 5Request a written cost estimate from the surgery office.
  6. 6Keep all pressure checks after surgery.

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