{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:47:44Z","timestamp":1787071664522,"version":"build-2736575974"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","license":[{"start":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T00:00:00Z","timestamp":1758758400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,10]]},"abstract":"\n Purpose:<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Design:<\/jats:title>\n Retrospective, comparative clinical study.<\/jats:p>\n <\/jats:sec>\n \n Participants:<\/jats:title>\n Sixty-nine eyes of 57 patients were recruited at tertiary care centres in North India from October 2023 to September 2024.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The mean baseline IOP was similar between both groups (23.93 \u00b1 6.84 mmHg vs. 20.67 \u00b1 6.89 mmHg,\n P<\/jats:italic>\n =\n <\/jats:p>\n <\/jats:sec>\n \n 0.184<\/jats:title>\n \n ). At 6 months, mean IOP reduced to 17.95 \u00b1 5.13 mmHg (\n P<\/jats:italic>\n < 0.001) in Group A and 15.09 \u00b1 5.03 mmHg (\n P<\/jats:italic>\n < 0.001) in Group B. Medication burden reduced from 2.07 \u00b1 1.39 mmHg to 1.05 \u00b1 0.71 (49.1%) in Group A and from 1.89 \u00b1 1.18 to 0.91 \u00b1 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 (\n P<\/jats:italic>\n < 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.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ijo.ijo_1195_25","type":"journal-article","created":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T12:00:32Z","timestamp":1758801632000},"page":"1497-1502","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Performance and Safety of reused Kahook Dual Blade for combined cataract and minimally invasive glaucoma surgery in open angle-glaucoma"],"prefix":"10.4103","volume":"73","author":[{"given":"Sahebaan","family":"Sethi","sequence":"first","affiliation":[{"name":"Department of Glaucoma, Arunodaya Deseret Eye Hospital, Gurgaon, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parikshit","family":"Dhir","sequence":"additional","affiliation":[{"name":"Department of Glaucoma, Dhir Hospital, Bhiwani, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,9,25]]},"reference":[{"key":"R1-20260420","doi-asserted-by":"crossref","first-page":"2081","DOI":"10.1016\/j.ophtha.2014.05.013","article-title":"Global prevalence of glaucoma and projections of glaucoma burden through 2040: A systematic review and meta-analysis","volume":"121","author":"Tham","year":"2014","journal-title":"Ophthalmology"},{"key":"R2-20260420","doi-asserted-by":"crossref","first-page":"195","DOI":"10.4103\/sjopt.sjopt_151_21","article-title":"Six months\u2019 follow-up of combined phacoemulsification-kahook dual blade excisional goniotomy","volume":"36","author":"Mechleb","year":"2022","journal-title":"Saudi J Ophthalmol"},{"key":"R3-20260420","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1016\/j.jcrs.2017.06.046","article-title":"Goniotomy with a single-use dual blade: Short-term results","volume":"43","author":"Greenwood","year":"2017","journal-title":"J Cataract Refract Surg"},{"key":"R4-20260420","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1038\/eye.2013.9","article-title":"The carbon footprint of cataract surgery","volume":"27","author":"Morris","year":"2013","journal-title":"Eye (Lond)"},{"key":"R5-20260420","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1097\/ICU.0000000000000228","article-title":"Carbon footprint and cost-effectiveness of cataract surgery","volume":"27","author":"Venkatesh","year":"2016","journal-title":"Curr Opin Ophthalmol"},{"key":"R6-20260420","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1016\/j.amjsurg.2018.07.021","article-title":"Greening the operating room","volume":"216","author":"Guetter","year":"2018","journal-title":"Am J Surg"},{"key":"R7-20260420","doi-asserted-by":"crossref","first-page":"2484","DOI":"10.4103\/ijo.IJO_2999_20","article-title":"Initial experience with phacoemulsification and goniotomy using the Kahook dual blade in advanced open-angle glaucoma: Six-month outcomes in Indian eyes","volume":"69","author":"Krishnamurthy","year":"2021","journal-title":"Indian J Ophthalmol"},{"key":"R8-20260420","doi-asserted-by":"crossref","first-page":"e259870","DOI":"10.1136\/bcr-2024-259870","article-title":"Generation 1 iStent occlusion in angle closure glaucoma as a reason for postoperative intraocular pressure spike treated using non-interventional methods","volume":"18","author":"Sethi","year":"2025","journal-title":"BMJ Case Rep"},{"key":"R9-20260420","first-page":"1","article-title":"Minimally invasive glaucoma surgery: A budget impact analysis and evaluation of patients\u2019 experiences, preferences, and values","volume":"19","year":"2019","journal-title":"Ont Health Technol Assess Ser"},{"key":"R10-20260420","first-page":"100195","article-title":"Barriers to MIGS adoption among glaucoma specialists in India: Insights from a targeted survey","volume":"2025","author":"Sethi","journal-title":"Asia Pac J Ophthalmol (Phila)"}],"container-title":["Indian Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_1195_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:50:40Z","timestamp":1787068240000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_1195_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,25]]},"references-count":10,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/ijo.ijo_1195_25","relation":{},"ISSN":["0301-4738","1998-3689"],"issn-type":[{"value":"0301-4738","type":"print"},{"value":"1998-3689","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,25]]},"assertion":[{"value":"2025-05-13","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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