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Cataract
Glaucoma

Comparing iStent and KDB Implants: Similar IOP reduction but varied medication effects

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Both iStent Inject implantation (iStent) and Kahook Dual Blade goniotomy (KDB), when combined with phacoemulsification, are effective in lowering intraocular pressure (IOP) in patients with mild to advanced open-angle glaucoma, according to a study. However, KDB appeared to offer a potential advantage in reducing medication dependency postoperatively compared to iStent.

This retrospective chart review of 153 patients at a single center, aimed to assess the 2-year outcomes of these procedures.

Both iStent and KDB procedures, when combined with phacoemulsification, resulted in a significant reduction in IOP across all stages of glaucoma. Specifically, the mean IOP decreased from baseline to 14.2±4.1 mm Hg in the iStent group and to 14.7±3.6 mm Hg in the KDB group after 2 years.

The study found that the number of medications required postoperatively was significantly reduced in both groups. However, patients who underwent KDB experienced a greater reduction in medications compared to those who received iStent implants.

The success criteria of the study, defined as IOP reduction of at least 20% with a postoperative IOP of no more than 18 mm Hg, were met by a similar proportion of patients in both groups. However, a higher percentage of patients in the KDB group achieved a reduction of at least 1 medication compared to the iStent group.

The study found that the efficacy of both procedures remained consistent across different stages of glaucoma severity, indicating their suitability for a broad range of patients.

Reference
Barkander A, Economou MA, Jóhannesson G. Outcomes of iStent Inject Versus Kahook Dual Blade Surgery in Glaucoma Patients Undergoing Cataract Surgery. J Glaucoma. 2023;32(10):e121-e128. doi: 10.1097/IJG.0000000000002243. Epub 2023 Jun 14. PMID: 37327470; PMCID: PMC10538610.

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