Performance and Safety of reused Kahook Dual Blade for combined cataract and minimally invasive glaucoma surgery in open angle-glaucoma.

Abstract

Purpose: To evaluate the performance and safety of reusing the Kahook Dual Blade (KDB) in patients with mild to moderate primary open-angle glaucoma and to assess its impact on clinical outcomes.

Design: Retrospective, comparative clinical study.

Participants: Sixty-nine eyes of 57 patients were recruited at tertiary care centres in North India from October 2023 to September 2024.

Methods: Eyes were assigned to two groups: Group A (n = 32) underwent phacoemulsification-goniotomy using a reused KDB after standardized sterilization; Group B (n = 37) underwent surgery with a new KDB. Primary outcomes measures included intraoperative challenges and surgical complications. Secondary outcome measures were intraocular pressure (IOP) reduction, number of antiglaucoma medications, and need for further interventions at 6 months.

Results: The mean baseline IOP was similar between both groups (23.93 ± 6.84 mmHg vs. 20.67 ± 6.89 mmHg, P =.

). At 6 months, mean IOP reduced to 17.95 ± 5.13 mmHg (P < 0.001) in Group A and 15.09 ± 5.03 mmHg (P < 0.001) in Group B. Medication burden reduced from 2.07 ± 1.39 mmHg to 1.05 ± 0.71 (49.1%) in Group A and from 1.89 ± 1.18 to 0.91 ± 0.57 (52%) in Group B. Intraoperative challenges, such as resistance during blade advancement and difficulty engaging the trabecular meshwork, were more frequent with reused blades (P < 0.05). One case of toxic anterior segment syndrome and two cases of postoperative peripheral anterior synechiae were noted in the reused group. Incomplete excision was reported more frequently in the reused group.

Conclusion: Reuse of the KDB blade after a single sterilization cycle is a clinically viable and economically sustainable option for glaucoma surgery when performed under stringent infection control protocols.