Using pilocarpine drops post goniotomy may reduce long-term glaucoma medication needs

Medical Xpress / CU Anschutz Medical Campus / Current Eye Research ^ | April 21, 2025 | Kara Mason / Julia L. Xia et al

[ConservativeMind]

Using pilocarpine eye drops following Kahook Dual Blade (KDB) goniotomy surgery may improve clinical outcomes for patients with glaucoma and reduce the need for future medications, according to research.

"The KDB goniotomy is a minimally invasive glaucoma surgery and there was some variability in the post-operative eye drop regimen among different providers," says Julia Xia, MD.

"Some of our providers prescribe pilocarpine drops and some do not," she continues.

The study analyzed 532 KDB goniotomy procedures between September 2015 and March 2020, with and without pilocarpine use, and measured surgical success, which the researchers defined as intraocular pressure less than 21 mmHg in addition to either a more than 20% reduction in intraocular pressure or the reduction of one or more topical glaucoma medications.

The group using pilocarpine drops had a significantly higher success rate in the first and third month after surgery as well as one year after surgery. They also required significantly fewer medications than the group that did not use pilocarpine.

There is no cure for glaucoma, so ophthalmologists are tasked with helping their patients manage the disease and the excessive intraocular pressure (IOP) that leads to vision problems.

Management often includes eye drops and surgeries that aim to reduce IOP. Goniotomy is a minimally invasive surgery that opens the trabecular meshwork, the eye's drainage system, and allows fluid to flow out of the eye, thus reducing pressure.

"Pilocarpine historically has been used to lower eye pressure, but it also shrinks the pupil and creates tension in key areas of the drainage pathway," Xia explains. "This theoretically helps ensure the pathway remains open after someone has healed from surgery which allows fluid to better flow out of the eye."

Patients in the study who used the drops typically did so for about a month following the procedure.

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TOPICS: Health/Medicine
KEYWORDS: glaucoma; goniotomy

[ConservativeMind]

Take Pilocarpine (Isopto Carpine or Salagen) after having this glaucoma surgery for best results.

[ConservativeMind]

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