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Greg D Fliney,1,* Eliott Kim,2,* Miriam Sarwana,3 Sze Wong,2 Tak Yee Tania Tai,2 Ji Liu,1 Soshian Sarrafpour,1 Nisha Chadha,2 Christopher C Teng1 1Yale University School of Medicine, Department of Ophthalmology and Visual Science, New Haven, CT, USA; 2Icahn School of Medicine at Mount Sinai/New York Eye and Ear, Eye and Vision Research Institute, New York, NY, USA; 3BCT Partners, Newark, NJ, USA*These authors contributed equally to this workCorrespondence: Christopher C Teng, Yale University School of Medicine, Department of Ophthalmology and Visual Science, 40 Temple Street Suite 3D, New Haven, CT, 06510, USA, Tel +1 203-785-2020, Fax +1 203-7856220, Email christopher.teng@yale.eduPurpose: To compare the safety and efficacy of Kahook Dual Blade (KDB) versus Trabectome with cataract surgery in reducing intraocular pressure (IOP) and medications used by patients with glaucoma.Methods: Retrospective chart review comparing eyes after KDB or Trabectome with cataract surgery at 2 academic centers. Surgical success was defined as IOP < 21 mmHg with ≥ 20% IOP reduction at post-operative month 12 (POM12). Changes in IOP, number of glaucoma medications, and adverse events were assessed.Results: Ninety eyes in the KDB group and 125 eyes in the Trabectome group were included. Mean changes in IOP at POM12 were − 1.9 ± 4.9 mmHg (11.2%, P = 0.002) in the KDB group and − 3.5 ± 5.5 mmHg (19.1%, P < 0.001) in the Trabectome group, without a significant difference between the groups (P = 0.20). Mean change in glaucoma medications at POM12 was − 0.8 ± 1.5 in the KDB group (58%, P < 0.001) and − 0.3 ± 1.3 (38%, P = 0.003) in the Trabectome group, with KDB having a greater decrease in medications (P = 0.02). The percentage of eyes achieving success was 30% for the KDB group and 54% for the Trabectome group (P = 0.01). Hyphema was the most common complication, with an incidence of 3% for the KDB group and 14% for the Trabectome group (P = 0.01).Conclusion: KDB or Trabectome with cataract surgery is safe and effective at lowering IOP and medication burden, with KDB resulting in a greater reduction in medications and Trabectome more frequently achieving success with an increased incidence of hyphema. Considering the study’s limitations, the outcomes were similar.Keywords: Kahook Dual Blade, Trabectome, goniotomy, minimally invasive glaucoma surgery |
