Outcomes of iStent Inject Versus Kahook Dual Blade Surgery in Glaucoma Patients Undergoing Cataract Surgery.
Barkander Anna, Economou M A, Jóhannesson Gauti
AI Summary
This study compared iStent Inject and Kahook Dual Blade with cataract surgery for glaucoma. Both effectively lowered IOP, but KDB significantly reduced more glaucoma medications, suggesting it may be more effective for medication reduction.
Abstract
Précis: iStent Inject implantation (iStent) or Kahook Dual Blade goniotomy (KDB) in combination with phacoemulsification have a similar IOP-lowering effect in all stages of glaucoma, and medications are significantly reduced, especially after KDB.
Purpose
To compare the 2-year efficacy and safety of iStent or KDB in combination with phacoemulsification in eyes with mild to advanced open angle glaucoma.
Methods
A retrospective chart review of 153 patients that received iStent or KDB in combination with phacoemulsification at a single center between March 2019 and August 2020. The main outcome parameters at 2 years were: (1) intraocular pressure (IOP)-reduction ≥20%, with a postoperative IOP ≤18 mm Hg, and (2) a reduction of ≥1 medication. Results were stratified by glaucoma grade.
Results
After 2 years, mean IOP was reduced from 20.3±6.1 to 14.2±4.1 mm Hg in the phaco-iStent group ( P <0.001) and from 20.1±6.1 to 14.7±3.6 mm Hg in the phaco-KDB group ( P <0.001). The mean number of medications was reduced from 3.0±0.9 to 2.6±1.1 in the Phaco-iStent group ( P =0.001) and from 2.3±1.0 to 1.5±1.3 in the Phaco-KDB group ( P <0.001). Success regarding IOP-reduction ≥20% with a postoperative IOP ≤18 mm Hg was met by 46% in the phaco-iStent group and by 51% in the phaco-KDB group. A reduction of ≥1 medication was met by 32% in the phaco-iStent group and by 53% in the phaco-KDB group ( P =0.013). Eyes with mild to moderate and advanced glaucoma responded equally well to the success criteria.
Conclusions
iStent and KDB, in combination with phacoemulsification, both lowered IOP effectively in all stages of glaucoma. More medications were reduced after KDB, suggesting that it may be a more effective procedure compared with iStent.
MeSH Terms
Shields Classification
Key Concepts5
iStent Inject implantation (iStent) or Kahook Dual Blade goniotomy (KDB) in combination with phacoemulsification have a similar IOP-lowering effect in all stages of glaucoma.
Medications are significantly reduced after iStent Inject implantation (iStent) or Kahook Dual Blade goniotomy (KDB) in combination with phacoemulsification, especially after KDB.
After 2 years, mean intraocular pressure (IOP) was reduced from 20.3±6.1 to 14.2±4.1 mm Hg in the phaco-iStent group (P <0.001) in patients with mild to advanced open angle glaucoma.
After 2 years, mean intraocular pressure (IOP) was reduced from 20.1±6.1 to 14.7±3.6 mm Hg in the phaco-KDB group (P <0.001) in patients with mild to advanced open angle glaucoma.
A reduction of ≥1 medication was met by 32% in the phaco-iStent group and by 53% in the phaco-KDB group (P =0.013) after 2 years in patients with mild to advanced open angle glaucoma.
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