Kahook Dual Blade shows advantages in surgical success and IOP control

Kahook Dual Blade (KDB) goniotomy offers higher surgical success rates and better intraocular pressure (IOP) reduction at 6 months compared to iStent/iStent inject implantation when combined with phacoemulsification, however, by 12 months, iStent inject achieves similar IOP reduction to KDB, according to a study.

The study included 14 trials analyzing 1,959 eyes (958 phaco-KDB and 1,000 phaco-Stent, including 753 iStent and 207 iStent inject cases). The phaco-KDB group had a higher surgical success rate compared to the phaco-Stent group (OR: 0.68, P = 0.01) and greater IOP reduction at 6 months (mean difference: 1.13 mmHg, P = 0.002). By 12 months, IOP reduction between groups was generally similar, though subgroup analysis highlighted better outcomes for KDB versus iStent alone.

Both approaches had comparable rates of medication reduction and adverse events. Researchers concluded that while KDB goniotomy may provide an edge in surgical success and mid-term IOP control, iStent inject outcomes were similar to KDB at 1 year.

Reference
Guedes J, Amaral DC, de Oliveira Caneca K, et al. Kahook Dual Blade Goniotomy versus iStent Implantation Combined with Phacoemulsification: A Systematic Review and Meta-analysis. J Glaucoma. 2024;doi: 10.1097/IJG.0000000000002522. Epub ahead of print. PMID: 39641580.