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Kahook Dual Blade versus Trabectome (KVT): Comparing Outcomes in Combination with Cataract Surgery.
Greg D Fliney1, Eliott Kim2, Miriam Sarwana3
1Yale University School of Medicine, Department of Ophthalmology and Visual Science, New Haven, CT, USA.
Clinical Ophthalmology (Auckland, N.Z.)
|January 17, 2023
Summary
This study compared Kahook Dual Blade (KDB) and Trabectome procedures combined with cataract surgery for glaucoma. Trabectome achieved better intraocular pressure reduction and success rates, while KDB led to a greater decrease in glaucoma medications.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Intraocular Pressure Management
Background:
- Glaucoma management often requires reducing intraocular pressure (IOP) and medication burden.
- Minimally invasive glaucoma surgeries (MIGS) offer alternatives to traditional treatments.
- Comparing novel MIGS devices like Kahook Dual Blade (KDB) against established procedures like Trabectome is crucial for surgical decision-making.
Purpose of the Study:
- To compare the safety and efficacy of Kahook Dual Blade (KDB) versus Trabectome when performed concurrently with cataract surgery.
- To evaluate the reduction in intraocular pressure (IOP) and glaucoma medication usage post-operatively.
- To assess and compare adverse event profiles between the two surgical techniques.
Main Methods:
- A retrospective chart review was conducted at two academic centers.
- Eyes undergoing combined KDB and cataract surgery were compared with those undergoing combined Trabectome and cataract surgery.
- Surgical success was defined as IOP <21 mmHg with ≥20% IOP reduction at 12 months post-operation.
Main Results:
- Both KDB and Trabectome demonstrated significant IOP reduction at 12 months post-operation, with Trabectome showing a trend towards greater reduction (19.1% vs 11.2%).
- The KDB group experienced a significantly greater reduction in glaucoma medications (58% vs 38%).
- Trabectome achieved a higher success rate (54% vs 30%), but also had a higher incidence of hyphema (14% vs 3%).
Conclusions:
- Both Kahook Dual Blade and Trabectome are safe and effective MIGS options when combined with cataract surgery for glaucoma patients.
- Trabectome demonstrated superior IOP control and success rates, whereas KDB offered a more substantial decrease in medication requirements.
- The choice between KDB and Trabectome may depend on balancing the need for medication reduction versus achieving target IOP with a lower risk of hyphema.
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