Posters

Hydrus microstent in refractory glaucoma: 12 month follow-up in a real-world cohort of patients in the SPECTRUM global hydrus registry

Poster Details

First Author: L. Au UNITED KINGDOM

Co Author(s):    S. Gandolfi   S. Lim   M. Nardi   M. Chiang   A. Fea        

Abstract Details

Purpose:

The objective of this study is to assess the effectiveness of an ab interno Schlemm’s canal dilating scaffold (Hydrus microstent) in patients with glaucoma who had previous failed incisional or cyclodestructive procedures.

Setting:

The study was conducted at 11 centers in Europe, Australia, and Canada as part of a global postmarket registry. All hydrus cases performed worldwide were reviewed and included in this study after meeting inclusion criteria

Methods:

All patients who had confirmed glaucoma diagnosis and at least one previous incisional or cyclodestructive glaucoma procedure. All patients received a single Hydrus microstent either as standalone procedure or combined with cataract surgery. All cases completed twelve months follow up. Medication and IOP measured with Goldmann applanation tonometry were the primary outcome measures.

Results:

Twenty patients aged 72.6±10.8 years with refractory glaucoma were included. Diagnoses were POAG (10/20), mixed mechanism (4/20), Pseudoexfoliation (4/20), Pigmentary (1/20), and angle closure glaucoma (1/20). Previous glaucoma procedures included trabeculectomy (14/20), tube shunt (3/20), and cyclophotocoagulation (3/20). Mean preop CD ratio and VF deviation were 0.8±0.1 and -9.4±7.3db respectively. Fifteen subjects underwent combined phaco-Hydrus surgery while 5 pseudophakic patients had stand-alone Hydrus insertion. At 12 months, both mean IOP and medication were significantly reduced compared to baseline (21.5±4.9 vs. 15.1±2.7 and 2.8±1.0 vs. 1.9±1.1 medications). 65% of patient had IOP ≤15mmHg with or without medications at 12 months.

Conclusions:

Implantation of the Hydrus Microstent is an effective treatment in patients with previously failed glaucoma surgery. Performed either as standalone or combined with cataract surgery resulted an average 6mmHg reduction in IOP at one year and a reduction of almost one medication. All patients had IOP <21mmHg and 75% of patients had >20% IOP reduction. The majority of patients achieved IOP ≤15mmHg despite their advanced glaucomatous status. Only one patient failed and had subsequent tube surgery. No sight threatening complication was observed during the post-op period.

Financial Disclosure:

One or more of the authors receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, One or more of the authors travel has been funded, fully or partially, by a competing company, One or more of the authors travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, One or more of the authors research is funded, fully or partially, by a competing company, One or more of the authors research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, One or more of the authors receives consulting fees, retainer, or contract payments from a competing company