Kahook Dual Blade: six-month results in uncontrolled open angle glaucoma

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Surgical Innovation

Background:

• Open-angle glaucoma (OAG) management often requires medication and surgical intervention to control intraocular pressure (IOP).
• Traditional trabeculectomy can be associated with complications, leading to interest in alternative ab interno techniques.
• The Kahook Dual Blade (KDB) offers a minimally invasive approach for trabeculectomy.

Purpose of the Study:

• To evaluate the efficacy and safety of bleb-free ab interno trabeculectomy using the KDB device.
• To assess the reduction in intraocular pressure (IOP) and medication usage post-KDB surgery.
• To analyze the surgical profile and complications associated with standalone KDB trabeculectomy.

Main Methods:

• Retrospective cohort study of patients with uncontrolled OAG undergoing standalone KDB ab interno trabeculectomy.
• Analysis of changes in IOP, topical IOP-lowering medications, and surgical outcomes over a 6-month follow-up period.
• Statistical analysis included calculation of means, standard deviations, and application of the Wilcoxon test.

Main Results:

• Mean IOP decreased by 40.6% from baseline to 6 months post-surgery (P<0.01).
• Average topical medication requirement reduced, with one-fifth of patients discontinuing medications.
• The procedure demonstrated a favorable safety profile, with mild hyphema as the most common complication.

Conclusions:

• Standalone KDB ab interno trabeculectomy is effective in significantly reducing IOP in uncontrolled OAG patients.
• The procedure is associated with favorable surgical safety and a decreased need for IOP-lowering medications.
• KDB trabeculectomy shows promise as a single-procedure glaucoma treatment, particularly in Caucasian populations, though long-term efficacy requires further study.