New World Medical announced data was presented comparing the IOP lowering efficacy of cataract extraction (CE) combined with either goniotomy performed with the Kahook Dual Blade (KDB, New World Medical) or trabecular meshwork microbypass device implantation (iStent, Glaukos Corporation, San Clemente, CA). These data were presented by Kaweh Mansouri, MD, MPH, of the Glaucoma Center, Montchoisi Clinic, Lausanne, Switzerland and the Department of Ophthalmology, University of Colorado, Denver, during the annual meeting of the European Society of Cataract and Refractive Surgeons (ESCRS) in Lisbon, Portugal.
The poster, entitled "Comparison of the Intraocular Pressure Lowering Efficacy Between a Novel Goniotomy Blade and a Trabecular Meshwork Device," includes data from a retrospective chart review of patients with mild-to-moderate glaucoma who underwent CE with either KDB goniotomy or iStent implantation. The study took place at 12 sites (11 US, 1 Mexico) and evaluated postoperative IOP as well as medication use of 435 eyes treated either by CE+KDB or CE+iStent (198 and 237 eyes, respectively).
At 6 months, the mean IOP in the CE+KDB cohort demonstrated a statistically significant greater reduction compared to CE+iStent (24% vs 16%, respectively, P<0.05). This result was statistically significant as early as day 1, with a reduction of 14% in the KDB group versus 4% in the iStent group, and continued through the 6-month study period. The mean reduction in medication use between the two groups was significantly different with a 63% reduction in the CE+KDB group (1.7 to 0.6 medications) compared to 46% in the CE+iStent group (1.9 to 1.0 medications), P<0.05. Both groups had similar baseline demographics and reported comparable adverse events, which were mild and self-limited.
“This large study demonstrates that goniotomy with the Kahook Dual Blade has the ability to provide significant reductions in IOP and medication use when compared to iStent for glaucoma patients undergoing cataract extraction” Dr. Mansouri said in a company news release. “These results represent an important advance in the surgical treatment for patients undergoing cataract surgery who have uncontrolled mild-to- moderate glaucoma or who want to reduce their medication burden.”