Phacoemulsification-KDB combo safely lessens IOP in open-angle glaucoma

22 Jun 2021

The combination of phacoemulsification and ab interno trabeculectomy using the Kahook Dual Blade (KDB) can help safely reduce intraocular pressure (IOP) in eyes with moderate to advanced open-angle glaucoma (OAG), a recent study has found.

Researchers conducted a retrospective review of the medical records of 26 patients (mean age 79.3±1.4 years, 61.6 percent women), contributing 32 eyes overall. In particular, they looked at IOP measurements and the use of IOP-lowering medications before surgery and up to 24 months after.

Over a mean follow-up of 11.5±1.0 months, significant drops in IOP were recorded. By week 6, for instance, IOP had dropped to 15.1±1.0 mm Hg from 19.8±0.8 mm Hg at baseline, which was statistically significant (p=0.002). This corresponded to an average reduction of 20±4.5 percent.

The effect remained significant even after 3–6 months, at which point mean IOP was 15.6±0.7 mm Hg (p<0.0001), an 18.7±4.2-percent drop from baseline values. At the final follow-up, average IOP was 15.5±0.6 mm Hg; this nearly 19-percent decrease relative to baseline was likewise significant (p<0.0001).

In turn, the phacoemulsification-KDB combo led to significant reductions in the use of IOP-lowering medications, such that by 3–6 months and at the final follow-up, medications had dropped by 98.3 percent and 82.5 percent, respectively (p<0.0001 for both).

Moreover, the procedure was well-tolerated, with no eyes requiring additional glaucoma procedures. Four eyes developed transient hyphema either intraoperatively or shortly after the procedure; all cases resolved spontaneously.

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