Abstract
Purpose :
Controversy exists regarding the efficacy and safety of Kahook Blade Dual (KDB) goniotomy compared to that of a second-generation trabecular micro-bypass stent (iStent inject) in combination with cataract extraction. We performed a retrospective, single-center, observational, longitudinal case series to compare the efficacy and safety of these two types of microinvasive glaucoma surgery (MIGS), as existent literature comparing MIGS procedure head-to-head is limited.
Methods :
All participants undergoing either of the MIGS procedure were included in our study. The intervention was combined with elective cataract extraction. Data collection included IOP, IOP-lowering medications and best-correct visual acuity (BCVA) preoperatively and at 1 day, 2 weeks, 1 month, 6 months and 12 months postoperatively. In addition, intraoperative and postoperative adverse events were also examined. The primary efficacy outcome was the proportion of patients in each group attaining 20% reduction of IOP. Subgroup analysis were conducted for different types of glaucoma.
Results :
A total of 29 patients (49 eyes) were included in the iStent inject group and 16 patients (22 eyes) in the KDB group. Mean follow-up was 6 months for both groups. Pre- and post-operative IOPs were 23.68 ± 6.06 mmHg and 12.8 ± 2.4 mmHg (P <0.0001) in the Phaco-KDB group as well as 21.51 ± 4.99 mmHg and 15 ± 1.91 mmHg (P <0.0001) in the Phaco-iStent inject group. No major complications occurred. Changes in IOP and medications were not significantly different between groups (P>0.05).
Conclusions :
KDB and iStent inject showed clinically significant IOP-lowering effect when combined with phacoemulsification. The IOP reduction by Phaco-KDB was equivalent to that by Phaco-iStent inject.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.