iStent inject® trabecular micro-bypass implantation vs microinvasive Kahook dual-blade goniotomy both combined with phacoemulsification: early 4 month results

Session Details

Session Title: Presented Poster Session: Glaucoma

Venue: Poster Village: Pod 2

First Author: : T.Snaebjörnsson Arnljots SWEDEN

Co Author(s): :    M. Economou                       

Abstract Details

Purpose:

To report early clinical results in an efficacy and safety comparison of combined iStent inject implantation vs. Kahook dual-blade goniotomy (KDB) in a primary open-angle glaucoma and pseudoexfoliative glaucoma setting.

Setting:

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

Methods:

Retrospective, non-randomized, consecutive case review of all patients that underwent iStent inject or KDB combined with cataract surgery from October 2016 to October 2017. All procedures were performed by the same surgeon.

Results:

Nineteen eyes that underwent phaco-iStent inject implantation and 10 eyes that had phaco-KDB performed were included. Mean pre- and postoperative IOPs in the iStent group 21.7 ± 5.6 and 15.2 ± 3.4 mmHg, mean reduction 6.6 ± 4.3 mmHg (p<0.0001); in the KDB group at 21.6 ± 2.5 and 15.3 ± 3.1 mmHg, mean reduction 6.3 ± 3.5 mmHg (p=0.0003). Number of antiglaucoma medications was reduced in both groups, from 3.0 ± 1.1 to 2.2 ± 1.1 (iStent) (p=0.001) and 2.9 ± 1.9 to 1.9 ± 1.7 (KDB) (p=0.0625). No sustained vision-threatening complications were observed. Mean follow-up was 4 months.

Conclusions:

Early clinical data demonstrate a similar and promising IOP reduction in each of the combined iStent inject and KDB procedure groups also resulting in reduced antiglaucomatous medication. Although one case of hypotony was encountered in the KDB group no long-term effects affecting vision were seen, rendering a satisfying safety profile for both techniques.

Financial Disclosure:

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