The current study aimed to explore the efficacy and safety of excisional goniotomy using the Kahook Dual Blade (KDB-GTE) in refractory glaucoma. A total of 20 eyes from 19 subjects with mild to late-stage refractory glaucoma who underwent standalone KDB goniotomyor combined phacoemulsification plusintraocular lens (IOL) implantation (partially combined withgoniosynechialysis) in Beijing Tongren Hospital from August 2021 to April 2023 were included. There were 9 males and 10 females, with a mean age of (57±17) years and a follow-up time of (19.8±6.4) months.The preoperative intraocular pressure (IOP) decreased from (29.4±11.8) mmHg (1 mmHg=0.133 kPa) to (15.7±2.6) mmHg (P<0.001). The types of preoperativeanti-glaucoma medications were reduced from 4 (3, 4) to 2 (1, 3) (P<0.001). At 12-month follow-up, 70% (14/20) achieved a IOP of≤18 mmHg after medication. No severe complications were reported. This study suggests that KDB-GTE is an effective and minimally invasive surgery for refractory glaucoma, demonstrating significant reductions in both IOP and medication burden, with a favorable safety profile.