Treatment Overview
Goniotomy in Korea is a minimally invasive, angle-based glaucoma surgery (MIGS) that improves natural aqueous humor drainage by opening the trabecular meshwork under direct gonioscopic visualization. Surgeons use ultra-fine blades, Kahook Dual Blade (KDB), microcatheters, or laser-assisted systems to create a precise incision in the trabecular meshwork, allowing fluid to flow more freely into Schlemm’s canal and lower intraocular pressure (IOP).
Korea is a global leader in goniotomy thanks to 3D digital gonioscopy, OCT-angle mapping, AI-guided incision planning, and precision micro-surgical instruments, ensuring high safety, fast recovery, and long-term pressure stability.
Purpose & Benefits
Purpose
- Lower IOP by opening or removing resistance at the trabecular meshwork.
- Restore natural fluid drainage without external incisions or bleb formation.
- Slow or prevent optic nerve damage progression in glaucoma patients.
- Provide a safe, minimally invasive treatment option for early to moderate glaucoma.
Benefits
- Blebless Procedure: Avoids risks associated with filtering surgeries.
- Minimally Invasive: Uses a tiny corneal incision (ab interno).
- Fast Recovery: Low inflammation and rapid healing.
- Physiological Outflow: Enhances the eye’s natural drainage system.
- Low Complication Rate: Extremely safe and tissue-sparing.
- Versatile: Effective across multiple glaucoma types, especially early and moderate disease.
- Ideal for Combination Surgery: Often paired with cataract surgery.
Ideal Candidates
Goniotomy in Korea is ideal for:
- Patients with mild, early, or moderate primary open-angle glaucoma (POAG).
- Individuals undergoing combined cataract + glaucoma surgery.
- Younger patients or those with juvenile glaucoma.
- Patients with secondary glaucomas, such as:
- Pigmentary glaucoma
- Pseudoexfoliative glaucoma
- Steroid-induced glaucoma
- Individuals who cannot tolerate medications or need extra IOP reduction after SLT.
- Those seeking a minimally invasive, fast-recovery glaucoma procedure.
Possible Risks & Complications
Although goniotomy is extremely safe, potential risks include:
- Transient hyphema: Small blood reflux that clears naturally in days.
- Temporary blurred vision: Improves as the eye heals.
- Mild inflammation: Easily controlled with anti-inflammatory drops.
- Short-term IOP fluctuations: Normalize within weeks.
- Angle re-closure (rare): Minimised with proper after-care and technique.
Korea minimizes risks through AI-assisted angle mapping, high-resolution gonioscopy, and precision surgical tools that ensure clean and accurate trabecular incisions.
Types of Goniotomy Performed in Korea
Traditional Blade Goniotomy
A micro-surgical blade precisely incises the trabecular meshwork.
Kahook Dual Blade (KDB) Goniotomy
Removes a strip of trabecular tissue for long-lasting drainage improvement.
360° Transluminal Goniotomy
Uses a microcatheter or suture to open Schlemm’s canal around its full circumference.
Femtosecond-Assisted Goniotomy
Laser-assisted incision planning enhances precision and consistency.
Combined Phaco–Goniotomy
Performed with cataract surgery for enhanced IOP reduction.
Surgical Techniques
AI-Based Angle Analysis
Evaluates trabecular thickness, pigmentation, and canal patency.
Ab Interno Micro-Incision Access
A tiny corneal incision allows access to the drainage angle internally.
High-Definition Gonioscopy
Digital or 3D gonioscopy provides clear visualization of the angle.
Precision Trabecular Incision
Blade, KDB, or catheter removes or opens the trabecular meshwork.
OCT-Guided Confirmation
Confirms successful access to Schlemm’s canal and uniform fluid passage.
Treatment Process in Korea
Step 1 – Comprehensive Glaucoma Evaluation
Includes IOP measurement, optic nerve OCT, angle imaging, and visual fields.
Step 2 – Surgical Planning
Surgeon selects incision type (blade, KDB, or catheter) and determines incision arc.
Step 3 – Goniotomy Procedure
A micro-incision is created, the angle is visualized, and the trabecular meshwork is opened or excised.
Step 4 – Immediate Postoperative Care
Anti-inflammatory drops are started; mild hyphema may appear temporarily.
Step 5 – Follow-Up Monitoring
Regular check-ups ensure IOP stability and proper healing.
Treatment Duration: 10–20 minutes per eye
Setting: Outpatient, same-day discharge
Recovery & After-Care
After-Care Guidelines
- Use prescribed anti-inflammatory and antibiotic drops for 2–4 weeks.
- Avoid rubbing the eyes and heavy exercise initially.
- Expect mild blood reflux, which is normal.
- Continue glaucoma medications only if instructed.
- Attend all follow-up visits for IOP monitoring.
Recovery Timeline
- Days 1–3: Mild blur or redness; hyphema starts clearing.
- Week 1: Significant improvement in IOP and visual clarity.
- Weeks 2–4: Angle stabilizes; vision returns to baseline or better.
- Months 1–3: Full, stable IOP reduction achieved.
Results & Longevity
Expected Results
- Effective IOP reduction for early to moderate glaucoma.
- Reduced reliance on glaucoma medications.
- Protection of optic nerve health.
- High success rate, especially when combined with cataract surgery.
Longevity
- Results typically last 5–10 years, depending on glaucoma severity.
- Can be repeated or enhanced with other MIGS procedures in the future.
- Korean outcomes show strong durability due to precise imaging and microsurgical accuracy.
Why Korea Is a Top Destination
- Leaders in MIGS and angle surgery, including blade, KDB, and 360° goniotomy.
- Advanced imaging systems such as 3D gonioscopy and angle-OCT.
- AI-enhanced surgical planning for personalized incision profiles.
- High surgical precision with minimal tissue trauma.
- Integrated glaucoma care systems with long-term monitoring.
Unique Korean Innovations
- AI-calibrated angle mapping for optimal incision placement.
- OCT-guided intraoperative visualization.
- Ultra-sharp micro-instruments for smooth trabecular removal.
- Hybrid techniques combining goniotomy with MIGS or canaloplasty.
- Predictive IOP modeling for long-term pressure stability.
Cost Range (Indicative Estimate)
| Treatment Package | Price (KRW) | Approx. USD | Inclusions |
|---|---|---|---|
| Standard Goniotomy | ₩1,500,000 – ₩2,500,000 | ~$1,100 – $1,900 | Ab-interno goniotomy + postoperative care |
| KDB Goniotomy Program | ₩2,800,000 – ₩4,000,000 | ~$2,100 – $3,000 | KDB-assisted goniotomy + imaging |
| Combined Cataract + Goniotomy | ₩4,500,000 – ₩6,500,000+ | ~$3,400 – $5,000+ | Phaco + goniotomy + full imaging package |
Popular Clinics in Korea
- B&VIIT Eye Center (Seoul) – Specialists in KDB and micro-incision goniotomy.
- Dream Eye Center (Seoul) – Leaders in MIGS and precision angle surgery.
- BGN Eye Clinic (Busan & Seoul) – Known for combined cataract + goniotomy procedures.
- Glory Seoul Eye Clinic – Experts in advanced gonioscopy and angle-based surgery.
- K-Cure Vision Center (Gangnam) – Innovators in AI-assisted goniotomy planning.
