Outcomes of Kahook Dual Blade Goniotomy with and without Phacoemulsification Cataract Extraction

Sieck, Erin G.; Epstein, Rebecca; Kennedy, Jeffrey B.; SooHoo, Jeffrey R.; Pantcheva, Mina B.; Patnaik, Jennifer L; Wagner, Brandie D.; Lynch, Anne M.; Kahook, Malik Y.; Seibold, Leonard K.

doi:10.1016/j.ogla.2018.06.006

Cited by 95 publications

(129 citation statements)

References 17 publications

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“…From our results, it would suffice to say that the IOP gradually reduces with time after the operation as seen in the relatively higher IOP before surgery as compared to IOP after one to 10 days, one to two months, and four to seven months (P=0.000) for all patients. The efficiency of KDB and cataract surgery in reducing IOP was observed, as was the case with Sieck (2018), in their investigation of the outcomes of KDB and phacoemulsification [6]. Due to the effectiveness of surgery, medication use was significantly lower after surgery (P-value=0.005), in the KDB+phaco group.…”

Section: Discussionmentioning

confidence: 80%

The Safety of the Kahook Dual Blade in the Surgical Treatment of Glaucoma

Barry

Alahmadi²,

Alahmadi³

et al. 2020

Cureus

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Intraocular pressure defects remain a significant problem in the medical field. Several methods have been employed to help reduce the effect of intraocular pressure (IOP), all of which have their merits and demerits. Considered in this paper are surgery and the Kahook Dual Blade (KDB; Kahook, New World Medical, Inc., Rancho Cucamonga, CA) process invented and tested during previous studies to reduce IOP. This study examines both methods; first, in combination with cataract surgery, and then, separately, to assess their effectiveness in reducing IOP. Objective The focus of the research is to establish the effectiveness and safety associated with goniotomy while utilizing the Kahook Dual Blade (KDB) procedure for reducing IOP and bringing down the reliance on hypotensive agents in a variety of glaucoma types, either independently or when combined with phacoemulsification (phaco) within the follow-up duration (four to seven months). Methods and design The setting was the outpatient clinics in Al-Maghrabi Hospital in Medina. It involved the use of a retrospective study for the study design. Fifty eyes from a total of 45 patients were reviewed. There was KDB in 10 eyes while KDB was integrated with the cataract surgical procedure in 40 eyes.

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Section: Discussionmentioning

confidence: 80%

The Safety of the Kahook Dual Blade in the Surgical Treatment of Glaucoma

Barry

Alahmadi²,

Alahmadi³

et al. 2020

Cureus

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“…Safety was excellent in this study, with no intraoperative nor stentrelated complications, and with few mild postoperative adverse events over the course of follow-up. There were no complications such as those seen with conventional filtering surgeries or some other MIGS devices (e.g., endophthalmitis, hypotony, choroidal detachment or effusion, significant hyphema, device dislocation) [6][7][8][51][52][53][54]. There also were no cases of inflammation (e.g., uveitis, iritis) or PAS, which have emerged as a concern with some MIGS devices, particularly those containing nickel [55][56][57].…”

Section: Discussionmentioning

confidence: 99%

Second-generation trabecular micro-bypass stent implantation: Retrospective analysis after 12- and 24-month follow-up

Neuhann¹,

Neuhann²

2020

Eye and Vis

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Background: The study aimed to investigate the 24-month safety and efficacy of implantation of two secondgeneration iStent inject trabecular micro-bypass stents with concomitant cataract surgery. Methods: This consecutive case series included 164 eyes of 109 patients implanted with the iStent inject® device with concomitant cataract surgery. The series was comprised of eyes with primary open-angle glaucoma (n = 84), pseudoexfoliation glaucoma (n = 42), normal-tension glaucoma (n = 18), and ocular hypertension (n = 20). All 164 eyes reached 9-14 months of follow-up ("12-month consistent cohort"), with a subset of 88 eyes reaching 21-26 months of follow-up ("24-month consistent cohort"). Performance outcome measures included intraocular pressure (IOP) and number of glaucoma medications. Safety outcomes included intra-or postoperative complications, the need for secondary procedures and corrected distance visual acuity. Comparisons of change in continuous (e.g., IOP) and categorical (e.g., proportions of eyes on zero medications) measures between baseline and postoperative times were made with the paired t-test and McNemar's chi-squared test, respectively. Results: At 12 months postoperatively, IOP was reduced by 25.5% (from 20.0 ± 5.5 mmHg to 14.9 ± 2.0 mmHg; p < 0.001); at 24 months postoperatively, IOP was reduced by 26.6% (from 20.3 ± 6.1 mmHg to 14.9 ± 1.9 mmHg; p < 0.001). At 12 months postoperatively, mean number of glaucoma medications was reduced by 85.0% (from 2.0 ± 1.0 to 0.3 ± 0.8 medications; p < 0.001); at 24 months postoperatively, mean number of medications was reduced by 81.0% (from 2.1 ± 1.1 to 0.4 ± 0.8 medications; p < 0.001). After 12 months, 96.3% of eyes had an IOP ≤ 18 mmHg and 58.5% of eyes had an IOP ≤ 15 mmHg, with 81.1% of eyes free of any medication, compared to 1.8% of eyes medication-free in the 12-month cohort at baseline. After 24 months, 98.9% of eyes had an IOP ≤ 18 mmHg and 53.4% of eyes had an IOP ≤ 15 mmHg, with 72.7% free of medication compared to 1.1% of eyes medication-free in the 24-month cohort at baseline. Overall, a high safety profile was observed with no significant postoperative complications. Conclusions: The insertion of iStent inject (comprised of two second-generation trabecular micro-bypass stents) with cataract surgery effectively provides a sustained reduction in IOP with a markedly improved medication burden up to 24 months postoperatively.

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“…Kahook Dual Blade only recently became a tool for anterior chamber angle surgery [6][7][8][9]. These eyes showed our first experience with this novel procedure.…”

Section: Discussionmentioning

confidence: 99%

“…The surgeries were performed by an experienced Glaucoma surgeon (OA) and a Glaucoma fellow (GIN). The surgical technique used in this study was as reported by Sieck EG, et al [9]. Postoperatively, patients who had combined KDB and phacoemulsification were started on Guttae Maxitiol 2hourly, Guttae Ciloxan (norvatis) 4hourly, Maxitriol ointment nocte daily which were tapered over an 8-week period.…”

Section: Methodsmentioning

confidence: 99%

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Short Term Outcome of Goniotomy with Kahook Dual Blade in the Management of Primary Open Angle Glaucoma-A Retrospective Interventional Case Series

2019

JOCR

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Objectives: To describe short-term efficacy of goniotomy with trabecular meshwork excision using the Kahook Dual Blade (KDB, New World Medical Inc., Rancho Cucamonga, CA) in patients with Primary Open Angle Glaucoma, (POAG) either as a standalone or plus Phacoemulsification (phaco). Method and Patients: A retrospective review of 12 eyes of 9 patients who had goniotomy with Kahook dual blade either as a standalone or combined with cataract surgery by phacoemulsification from April 2017 to July 2018 at Eye Foundation Hospital, Ikeja, Lagos. The patients were follow-up for a minimum of 6 months. Results: The mean age of the patients was 66.4±8.8 years. Mean preoperative intraocular pressure (IOP) for all eyes was 18.58±5.42mmHg. From day 1 through the 6th Month of postoperative follow-up, the mean IOP ranged from 18.58±9.26mmHg to 12.27±1.68mmHg representing reductions of 0-6.31mmHg (0-34%; p<0.05 at each time point versus baseline except for day 1). For the Phaco+KDB group, the baseline mean IOP was 19.25±4.56mmHg while the mean IOP postoperatively from day 1 to 6 months ranged from 19.13±8.99mmHg to 12.13±1.89mmHg representing reductions of 0.12mmHg to 5.13mmHg (0.6-30.2%; p<0.05 only from 1 month to 6 months). At baseline, the mean IOP for the eyes that had KDB goniotomy as a standalone was 17.25±7.45mmHg and postoperatively ranged from 17.50±11.09mmHg to 12.67±1.67mmHg representing reductions of -0.25-9.08mmHg (-1.45%-41.7%; p<0.05 at one week, 3 and 6 months only versus baseline). Conclusion: KDB either as a standalone or with phaco recorded at least 30% reduction in IOP after 6 months of followup in these series.

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Outcomes of Kahook Dual Blade Goniotomy with and without Phacoemulsification Cataract Extraction

Cited by 95 publications

References 17 publications

The Safety of the Kahook Dual Blade in the Surgical Treatment of Glaucoma

The Safety of the Kahook Dual Blade in the Surgical Treatment of Glaucoma

Second-generation trabecular micro-bypass stent implantation: Retrospective analysis after 12- and 24-month follow-up

Short Term Outcome of Goniotomy with Kahook Dual Blade in the Management of Primary Open Angle Glaucoma-A Retrospective Interventional Case Series

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