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Suhail Abdullah, Mark C Jasek, Nathan M. Radcliffe, Jesus Jiménez-Roman, Leonard Seibold, Gabriel S Lazcano, John Palmer Berdahl; A Novel Dual Blade Device for Goniotomy: Initial Clinical Experience. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6522.
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© ARVO (1962-2015); The Authors (2016-present)
A novel ophthalmic knife, the Kahook Dual Blade (KDB, New World Medical, Inc.), is designed to excise trabecular meshwork tissue. A survey of the surgeons’ operating room experience with the KDB was conducted and patient charts were retrospectively reviewed to evaluate procedure safety.
KDB Goniotomy was performed by five glaucoma fellowship trained surgeons, in a total of 32 adult glaucomatous eyes. Data collection included information on glaucoma type and severity, concurrent surgeries, preoperative glaucoma medications, intraocular pressure (IOP), and intraoperative complications. Surgeons also responded to questions about ease of use of the KDB. In subsequent follow up visits, patient IOP, glaucoma medications, and complications were recorded.
65.6% of patients had primary open angle glaucoma, 18.8% had pseudoexfoliation glaucoma and 15.6% had chronic angle closure glaucoma. 50% of patients had severe glaucoma and 38% had moderate glaucoma as rated by the treating physician. The KDB was used in conjunction with cataract surgery in 81% of cases. In 31% of these cases, endocyclophotocoagulation was also performed. In 97% of cases, surgeons either strongly agreed or agreed that use of the KDB was straightforward, entry into the Schlemm’s Canal (SC) with the device was uncomplicated and advancement of the instrument was easy. Mean preoperative IOP of 16.5 mm Hg (SD 5.7) was reduced to 13.9 mm Hg (SD: 4.1, n=19, p=0.049) at one month with no reported complications. Mean number of glaucoma medications was reduced from 2.1 (SD 1.0) preoperatively to 0.6 (SD 1.0, p<0.001) at last follow up. In 75% of patients, blood reflux was observed intraoperatively, indicating patent distal outflow pathways. There were no serious intraoperative complications related to the device.
In this initial survey of surgical experience with a novel dual blade device, surgeons were satisfied with usability and safety of the device. Data collection on a larger number of patients with longer follow-up is ongoing.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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