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Clin Exp Ophthalmol. 2017 Mar;45(2):120-127. doi: 10.1111/ceo.12805. Epub 2016 Aug 24.

Hydrus microstent compared to selective laser trabeculoplasty in primary open angle glaucoma: one year results.

Author information

1
Department of Surgical Sciences, University of Turin, Ophthalmologic Unit, Turin, Italy.
2
Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.
3
Department of Medical, Surgical and Neuroscience, University of Siena, Santa Maria alle Scotte Hospital, Siena, Italy.

Abstract

BACKGROUND:

To compare the reduction of intraocular pressure (IOP) and glaucoma medications following selective laser trabeculoplasty (SLT) versus stand-alone placement of the Hydrus microstent, a microinvasive glaucoma surgery device.

DESIGN:

Prospective interventional case-series. University practice.

PARTICIPANTS:

Fifty six eyes (56 patients) with uncontrolled primary open-angle glaucoma.

METHODS:

Patients received either SLT (n = 25) or Hydrus implantation (n = 31) in two centres. Patients were evaluated at baseline and 1, 7 days, 1, 3, 6 and 12 months after surgery.

MAIN OUTCOME MEASURES:

Intraocular pressure and number of glaucoma medications variations inter-groups and intra-groups.

RESULTS:

There were no significant differences at baseline between groups, but the mean deviation was worse in the Hydrus group (-8.43 ± 6.84 dB, confidence limits (CL)-2.8/-3.3 vs.-3.04 ± 0.65 dB, CL-6/-10.8; P < 0.001). After 12 months, there was a significant decrease in IOP and medications in the Hydrus group compared with baseline values. In the SLT group, only the decrease in IOP was significant. There was 3-fold greater reduction in medication use in the Hydrus group compared with SLT (-1.4 ± 0.97 vs.-0.5 ± 1.05, P = 0.001). 47% of patients were medication free at 12 months in the Hydrus group (4% in the SLT group). No complications were recorded in the SLT group. In the Hydrus group, three patients experienced a temporary reduction of visual acuity post-operatively, and two patients had post-operative IOP spikes that resolved within one week.

CONCLUSIONS:

Both SLT and Hydrus implantation reduced IOP without serious adverse events. Hydrus implantation led to a significant and further reduction in medication dependence at 12 months.

KEYWORDS:

Hydrus; SLT; glaucoma; minimally invasive glaucoma surgery; trabecular surgery

PMID:
27449488
DOI:
10.1111/ceo.12805
[Indexed for MEDLINE]

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