Purpose: To compare the 12-month outcomes of cataract surgery combined with iStent Inject W or Kahook Dual Blade Glide versus cataract surgery alone.
Design: A prospective, randomized controlled trial conducted at a single center in Sweden.
Participants: Adult patients with cataract and medically treated ocular hypertension or mild to advanced primary open-angle glaucoma or pseudoexfoliative glaucoma.
Methods: Patients were randomized 1:1:1 to cataract surgery with iStent Inject W (cataract-iStent group, n = 40), cataract surgery with Kahook Dual Blade Glide (cataract-KDB group, n = 40), or cataract surgery alone (cataract group, n = 40), and followed for 12 months.
Main Outcome Measures: The primary effectiveness endpoints were surgical success, defined as a reduction in intraocular pressure (IOP) of ≥20% or a reduction of ≥1 medication, and change in IOP and ocular hypotensive medications at 12 months. Secondary endpoints included threshold IOP levels and adverse events.
Results: At 12 months, the rate of surgical success was higher in the cataract-iStent and cataract-KDB groups compared to the cataract group (87.5% vs. 52.5%, P < 0.001). Mean reduction in IOP was similar between groups (–3.0, –3.5, and –2.8 mmHg, P = 0.755), while reduction in medication was higher in the cataract-iStent and cataract-KDB groups compared to the cataract group (–0.8 and –0.9 vs. –0.4, P = 0.01). The main adverse events were transient hyphema (15% in the cataract-KDB group) and IOP spikes (37.5% in the cataract group, 10% in the cataract-iStent group, and 15% in the cataract-KDB group, P = 0.006). Additional glaucoma surgery was required in 1 eye (in the cataract group), and added therapy or selective laser trabeculoplasty was required in 4 eyes (3 in the cataract group and 1 in the cataract-KDB group).
Conclusions: Combined cataract surgery with iStent Inject W or Kahook Dual Blade Glide achieved significantly greater surgical success compared to cataract surgery alone, and this was due to a greater reduction in number of hypotensive medications.
Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Elsevier, 2026. Vol. 9, nr 3, s. 257-266