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KDB ARTICULO

Kahook Dual Blade: el mejor método para remover la malla trabeular

El glaucoma es una de las principales enfermedades causantes de ceguera en todo el mundo.  Todas las terapias actuales para el glaucoma tienen como objetivo la reducción de la presión intraocular mediante el uso de medicamentos orales o tópicos, láser o terapia quirúrgica.

Durante mucho tiempo se ha pensado, que es en la malla trabecular el sitio de mayor resistencia al flujo acuoso. La incisión y / o extracción de la malla trabecular, es decir, la t goniotomía, se ha utilizado con éxito durante mucho tiempo para disminuir la presión intraocular en el glaucoma congénito durante años. Más recientemente, también se ha demostrado que es ventajosa en pacientes adultos.

El Kahook Dual Blade (KDB), de la marca New World Medical, es un bisturí para goniotomía creado para producir una eliminación más completa de la malla trabecular. Esto se logra, a través de un enfoque mínimamente invasivo. Se lanzó en los Estados Unidos en 2015 y se diseñó para lograr una remoción casi completa de la malla trabecular, con un daño mínimo o nulo en el tejido.

Un estudio preclínico sobre bordes corneo-esclerales de donantes humanos, demostró histológicamente la eliminación más completa de la malla trabecular y con menos daño al tejido circundante con el KDB. Esto se hizo en comparación con Trabectome y una trabeculotomía con cuchilla MVR. 

La doble cuchilla tiene varias características de diseño clave para lograr una goniotomía más completa. Primero está la punta afilada diseñada con una forma cónica para permitir una entrada suave de la cuchilla a través de la malla trabecular (MT) y el Canal de Schelmm (CS). El talón del dispositivo encaja fácilmente dentro del CS y permite un avance suave de la cuchilla dentro del canal al tiempo que evita el daño colateral durante el tratamiento. La rampa de la cuchilla genera un estiramiento suave de la MT a medida que la cuchilla avanza. Finalmente, las cuchillas dobles crean incisiones paralelas de la MT que permiten la escisión de una tira de MT que logra una remoción casi completa, en lugar de solo la incisión. Un beneficio adicional del KDB, es que es un instrumento desechable de un solo uso que no requiere ningún equipo quirúrgico especial adicional. Además, no hay riesgos relacionados con el implante, ya que no se deja ningún implante con este procedimiento.

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