Hydrus microstent leads to long-term reduction in intraocular pressure and antiglaucoma medications in Sydney glaucoma patients

Abstract

PURPOSE: To assess the real-world long-term efficacy and safety of the Hydrus Microstent in glaucomatous eyes in local Sydney patients. METHODS: In this real-world cohort study, we assess change in IOP, number of antiglaucoma medications, and VF testing results of glaucomatous eyes in Hydrus or Hydrus with concomitant cataract surgery patients of two private Western Sydney ophthalmology clinics and Westmead hospital, from 2016 onwards. We also assess the frequency of intra- and postoperative complications. Patient data was extracted into the Fighting Glaucoma Blindness! Registry and data analysis performed using SAS 9.4 software. Paired t-tests with alpha-value of 0.05 were used to assess significance between baseline preoperative values and postoperative follow-up results. RESULTS: One hundred and thirty-nine eyes from 117 patients underwent standalone Hydrus or Hydrus with concomitant cataract surgery. There was maintained significant reduction in IOP from preoperative 17.58 +/- 6.56 mmHg to 12.65 - 3.63 mmHg (p = 0.0013) at 6-years follow-up, and in number of antiglaucoma medications from 2.15 +/- 1.40 to 1.34 +/- 1.35 (p = 0.0023) at five-years follow-up, although there was no maintained significant difference in VF measures beyond the early postoperative period. There were no recorded intraoperative complications and low rates of postoperative complications, including IOP spikes (3.6%), hyphaema (2.9%), corneal decompensation (2.9%), anterior uveitis (2.9%), device malposition (2.3%), infective ophthalmitis (0.79%) and peripheral anterior synechiae (0.79%). CONCLUSIONS: Hydrus, with or without concomitant cataract surgery, is an efficacious and safe intervention for reducing IOP out to six-years and medications out to five-years in glaucomatous eyes in Sydney patients, despite a lack of sustained reduction in VF measures.