Greg D Fliney, Eliott Kim, Miriam Sarwana, Sze Wong, Tak Yee Tania Tai, Ji Liu, Soshian Sarrafpour, Nisha Chadha, Christopher C Teng
{"title":"Kahook双刀与小梁刀(KVT):联合白内障手术的疗效比较。","authors":"Greg D Fliney, Eliott Kim, Miriam Sarwana, Sze Wong, Tak Yee Tania Tai, Ji Liu, Soshian Sarrafpour, Nisha Chadha, Christopher C Teng","doi":"10.2147/OPTH.S391527","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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%, <i>P</i> = 0.002) in the KDB group and -3.5 ± 5.5 mmHg (19.1%, <i>P</i> < 0.001) in the Trabectome group, without a significant difference between the groups (<i>P</i> = 0.20). Mean change in glaucoma medications at POM12 was -0.8 ± 1.5 in the KDB group (58%, <i>P</i> < 0.001) and -0.3 ± 1.3 (38%, <i>P</i> = 0.003) in the Trabectome group, with KDB having a greater decrease in medications (<i>P</i> = 0.02). The percentage of eyes achieving success was 30% for the KDB group and 54% for the Trabectome group (<i>P</i> = 0.01). Hyphema was the most common complication, with an incidence of 3% for the KDB group and 14% for the Trabectome group (<i>P</i> = 0.01).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":10442,"journal":{"name":"Clinical ophthalmology","volume":"17 ","pages":"145-154"},"PeriodicalIF":1.8000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ae/63/opth-17-145.PMC9840398.pdf","citationCount":"3","resultStr":"{\"title\":\"Kahook Dual Blade versus Trabectome (KVT): Comparing Outcomes in Combination with Cataract Surgery.\",\"authors\":\"Greg D Fliney, Eliott Kim, Miriam Sarwana, Sze Wong, Tak Yee Tania Tai, Ji Liu, Soshian Sarrafpour, Nisha Chadha, Christopher C Teng\",\"doi\":\"10.2147/OPTH.S391527\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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%, <i>P</i> = 0.002) in the KDB group and -3.5 ± 5.5 mmHg (19.1%, <i>P</i> < 0.001) in the Trabectome group, without a significant difference between the groups (<i>P</i> = 0.20). Mean change in glaucoma medications at POM12 was -0.8 ± 1.5 in the KDB group (58%, <i>P</i> < 0.001) and -0.3 ± 1.3 (38%, <i>P</i> = 0.003) in the Trabectome group, with KDB having a greater decrease in medications (<i>P</i> = 0.02). The percentage of eyes achieving success was 30% for the KDB group and 54% for the Trabectome group (<i>P</i> = 0.01). Hyphema was the most common complication, with an incidence of 3% for the KDB group and 14% for the Trabectome group (<i>P</i> = 0.01).</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":10442,\"journal\":{\"name\":\"Clinical ophthalmology\",\"volume\":\"17 \",\"pages\":\"145-154\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ae/63/opth-17-145.PMC9840398.pdf\",\"citationCount\":\"3\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical ophthalmology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2147/OPTH.S391527\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical ophthalmology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2147/OPTH.S391527","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
Kahook Dual Blade versus Trabectome (KVT): Comparing Outcomes in Combination with Cataract Surgery.
Purpose: 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.