Hydrus® Trabecular Bypass Microstent With Phacoemulsification In Primary Angle Closure Glaucoma: 6 Months Of Efficacy And Safety.

To evaluate the efficacy and safety of Hydrus® Trabecular bypass Microstent in patients with primary angle closure glaucoma following visco-goniosynechialysis in cataract surgery. The focus being the IOP control, a number hypotensive medication before and after surgery, and complications due to stent implant.

Retrospective record review of patients with mild to moderate primary angle closure glaucoma who had cataract surgery and Hydrus® Microstent, after visco-goniosynechialysis, in Broomfield Hospital (Mid and South Essex NHS Trust, UK) between January 2022 and August 2023.

Results included visual acuity and mean intraocular pressure (IOP) (+/- Standard Deviation) at baseline and at week 1, 2, 4, 8, 16, and 24 following the surgery, a number of hypotensive drops used (+/- SD), early post operative complication, or stent position.

23 eyes of 19 patients were reviewed. In one patient the Hydrus stent insertion was abandoned due to poor visualization of the trabecular meshwork. At week 24, the visual acuity improved from 0.42 (+/- 0.18) to 0.15 (+/- 0.13) logMar (p 0.03), while mean IOP dropped from 22.5 (+/-3.5) to 13.5 (+/- 3.1) mmhg (p = 0.02). The average number of hypotensive drops decreased from 1.8 (+/- 0.7) to 1.2 (+/- 0.7) (p = 0.05). A mild anterior chamber reaction was documented in four patients (16%), which resolved within 4 weeks. One patient experienced CMO, which resolved with topical treatment at week 16. One patient with moderate glaucoma required trabeculectomy due to uncontrolled IOP. No IOP spikes recorded on any patients over observation period.

Based on the above review Hydrus® Trabecular bypass Microstent could be considered a safe and effective choice in patients with mild to moderate primary angle closure glaucoma, undergoing routine cataract surgery, for a good IOP control and with the aim to reduce number of drops medicaiton intake.