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    Device makers swing for fence with new technologies


    New World Medical

    The Kahook Dual Blade, or KDB, made by New World Medical, continues to move toward broader testing and eventual commercialization. The hand-held instrument penetrates to the eye and the trabecular meshwork to the inner wall of Schlemm’s canal. A ramp elevates the meshwork to a pair of blades that excise the lifted tissue to restore drainage.

    “This device allows for a very clear and efficient ab interno trabeculectomy,” said Ahmad A. Aref, MD, professor of ophthalmology, University of Illinois Chicago. “There is very little collateral damage to the surrounding ocular structures and very little remnant trabecular tissue.”

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    Early clinical testing by 11 surgeons at 9 sites has been promising, Dr. Aref pointed out. Clinical results were positive. Patients had a mean IOP of 18.3 mm Hg before surgery despite a mean of 2.0 IOP-lowering medications. The day after surgery mean IOP had fallen to 11.29 mm Hg with a mean of 0.7 medications. At 3 months, the mean IOP was 12.1 mm Hg with 1.1 medications.

    Surgeons overwhelmingly agreed that the KDB is straightforward to use, provides uncomplicated entry into Schlemm’s canal and has easy advancement along the canal. There were no serious adverse events and a 48% rate of intraoperative hyphema indicated a functional collector system, Dr. Aref noted. Additional studies are planned.

    “This is a cost-effective procedure that is within existing procedure codes that restores the eye’s natural drainage pathway,” he said. “We can use the existing code for goniotomy and it can be done with or without cataract surgery.”


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