Kahook Dual Blade: comparison of safety and efficacy of combined cataract plus ab-interno trabeculectomy vs cataract alone

Session Details

Session Title: Moderated Poster Session: Cataract
Session Date/Time: Friday 15/02/2019 | 14:00-15:00
Paper Time: 14:00
Venue: Poster Area


First Author: N.Ventura Abreu SPAIN
Co Author(s): J. Martinez-de-la-Casa  J. Curbelo  L. Morales-Fernandez  S. Garcia-Caride  J. Garcia-Feijoo     

Abstract Details

Purpose:

This study is aimed to compare the efficacy and safety profile of combined cataract plus ab-interno trabeculectomy with a new device, the Kahook Dual Blade® (KDB), vs cataract surgery alone for treating mild-to-moderate open angle glaucoma (OAG) in patients undergoing cataract surgery

Setting:

Glaucoma Section, Department of Ophthalmology, Hospital Clinico San Carlos, Madrid

Methods:

This is a controlled, randomized clinical trial. 42 eyes of 33 patients, 18 years or older were enrolled. Eligibility criteria included medicated, OAG with mean intraocular pressure (IOP, mmHg) below 25 and indications of phacoemulsification cataract surgery. After signing written informed consent, patients were randomly assigned to treatment group (cataract plus KDB, A) or control group (cataract alone, B). All surgeries were performed by the same experienced surgeon. Clinical course after surgery was assessed at 1 weak, and 1, 3 and 6 months after surgery. Outcome measures included were mean IOP change, medication use and safety profile (adverse events, AEs).

Results:

Preoperative mean IOPs were similar in both groups: 17.86 +/- 3.45 in A and 17.29 +/- 2.51 in B. At sixth month, mean IOP reduction was statistically significant in group A (2.98, p = 0.0128) and in group B (1.93, p = 0.0092). However, no differences were found between groups (0.24, p = 0.81). Mean medication decreased from 1.57 +/-0.75 drugs to 0.14 +/-0.36 in A and from 1.38 +/-0.59 to 0.09 +/- 0.3 in B, finding no differences (p = 0.64). AEs found was one patient (A) with cystoid macular edema that resolved after intravitreal injection of dexamethasone implant

Conclusions:

Patients who undergo combined cataract and ab-interno trabeculectomy with KDB are found to experience a significant decrease in IOP and number of drugs. However, compared to phacoemulsification alone, no statistically differences were found so far. Longer follow-up and an increase in number of subjects may be necessary to find these differences.

Financial Disclosure:

receives consulting fees, retainer, or contract payments from a competing company