Posters

Kahook Dual Blade goniotomy vs iStent inject® implantation in open-angle glaucoma: preliminary 1-year efficacy and safety comparison

Poster Details

First Author: T.Arnljots SWEDEN

Co Author(s):    M. Economou                    

Abstract Details

Purpose:

Comparison of Kahook Dual Blade (KDB) goniotomy and iStent inject implantation in a safety and efficacy study.

Setting:

St. Erik Eye Hospital at the Karolinska Institute in Stockholm is a tertiary referral center for glaucoma surgery serving the whole of Sweden.

Methods:

The study was performed as a retrospective, non-randomised, case review of all patients that underwent either KDB goniotomy or iStent inject implantation between October 2016 and November 2017. Both surgeries were performed either as stand alone procedures or combined with standard phacoemulsification cataract surgery. Primary outcomes were intraocular pressure (IOP), visual acuity, number of glaucoma medications and complications. All surgeries were performed by the same experienced surgeon (MAE).

Results:

A total of 44 eyes with mainly open-angle glaucoma were included. Fifteen eyes underwent KDB goniotomy (6 single, 9 combined) and 29 eyes had iStent (12 single, 17 combined). Mean pre- and postoperative IOPs were 22.3 ± 4.6 and 15.0 ± 2.8 mmHg (p < 0.0001) as well as 21.1 ± 5.4 and 16.6 ± 5.1 mmHg (p < 0.0001), respectively. Mean number of glaucoma medications were 3.0 ± 1.6 and 1.9 ± 1.7 (p = 0.0137) and 2.9 ± 1.1 and 2.4 ± 1 (p = 0.0068), mean follow-ups 13.1 ± 3.9 and 12.3 ± 5.8 months, respectively.

Conclusions:

Despite important limitations in study design this study indicates a clinically significant IOP-lowering effect and reduction of glaucoma medications without any major complications in both subgroups, possibly in favor of KDB goniotomy at least in this setting. A larger, randomized, prospective study is already underway to further clarify the relative advantages and shortcomings of the techniques as well as which patients may benefit most from the procedures.

Financial Disclosure:

... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented