Kahook Dual Blade reduces IOP with and without phaco

SAN FRANCISCO — The Kahook Dual Blade procedure, with or without phacoemulsification, reduced IOP at 18 months, even more so in eyes with pseudoexfoliation, according to a poster presented here.

“[We found] that 30% of eyes had an IOP reduction greater than 18% to 20%, and 60% were able to get off one drop,” first author Faith A. Birnbaum, MD, of Duke Eye Center, told Healio.com/OSN at the American Glaucoma Society annual meeting.

Of 116 eyes of 100 patients, the Kahook Dual Blade procedure (New World Medical) was performed with phacoemulsification in 93 eyes or alone in 23 eyes. All surgeries were performed by a single surgeon, Mohammed K. ElMallah, MD, of Ocala Eye, Florida. According to Birnbaum, mean baseline IOP for all patients was approximately 18 mm Hg, which decreased to approximately 14.9 mm Hg at 18 months. Concurrently, mean number of medications decreased from 2.5 at baseline to approximately 1.6. In patients with pseudoexfoliation, mean IOP at baseline was approximately 19 mm Hg, decreasing to approximately 13 mm Hg at 18 months, with mean number of medications decreasing from 3 to approximately 1.7. 

“Most of our eyes were open angle glaucoma, about 80% of them. We did have a substantial number of pseudoexfoliation as well. That effect was greater for pseudoexfoliation,” Birnbaum said.

The two most common adverse events were hyphemas and IOP spikes greater than 10 mm Hg. The majority of hyphemas were transient, resolving within the first 2 weeks, and most IOP spikes had resolved by the 1 month visit, according to Birnbaum.

“On average, people will get off of one eye drop at a year and a half, and on average the starting pressure is 18 mm Hg and decreased to around 15 mm Hg in all eyes,” Birnbaum said. – by Patricia Nale, ELS

 

Reference:

Birnbaum FA, et al. 18-month efficacy and safety of Kahook Dual Blade goniotomy. Presented at: American Glaucoma Society annual meeting; March 14-17, 2019; San Francisco.

Disclosure: Birnbaum reports no relevant financial disclosures. ElMallah reports receiving prior research funding from New World Medical.

Editor's Note: This article has been updated to include additional data provided by Faith A. Birnbaum, MD.