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

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.