■ Researchers led by Linda Burk, MD, of the University of Texas Southwestern Medical Center, evaluated a hybrid MIGS procedure that combines a Kahook Dual Blade (New World Medical) and direct viscodilation of the collector channels with cataract surgery in reducing medications and IOP in mild, moderate, and severe glaucoma.
After cataract surgery, the Kahook Dual Blade removed 180 degrees of trabecular meshwork, exposing the ostium of the collector channels. Viscoelastic was then injected into the collector channels as the perpendicular cannula was held against the outer wall and dragged through the gutted canal. IOP was checked for steroid response and glaucoma drops were added as needed.
Overall, 66 eyes were assessed at 15 months follow-up in this group. Initial mean IOP was 19.7 mmHg with a mean of 1.9 medications. The mean IOP was 16.1 mmHg at 3 months and 16.5 mmHg at 15 months. There was no incidence of choroidal detachments, cyclodialysis clefts, or hypotony, while 90% of eyes had IOP <21 mmHg and 89% of all glaucoma drops were eliminated. A 16% overall reduction in IOP was achieved and 86.4% of eyes were off all medications. The researchers concluded that this hybrid MIGS technique produced significant reduction of IOP and medications.