Real World Outcomes From Hydrus Minimally Invasive Glaucoma Surgery

Minimally invasive glaucoma surgery (MIGS) aims to reduce reliance on topical medications as well as aiming to offer a safer, less invasive alternative method of reducing IOP than traditional surgery. At present, there are several approaches utilised by MIGS such as the Hydrus stent which increases trabecular outflow. MIGs can be combined with cataract surgery via phacoemulsification.

Aim: To assess the outcome of intraocular pressure (IOP) following Hydrus MIGs with treatment-requiring glaucoma.

Anonymised data was extracted at one centre from an electronic medical record system.

Inclusion criteria: Eyes undergoing Hydrus implant in patients with treatment-requiring glaucoma prior to study start. The minimum dataset included: age, IOP, best corrected visual acuity (BCVA) prior to surgery, timing of surgery, type of glaucoma and type of MIG procedure.

Primary outcome measure: IOP at 2 week, 6 week and 3 months post-surgery.

Twenty eyes met the inclusion criteria, average age of patients was 74. 11 had primary open angle glaucoma, 3 had normal tension glaucoma, 3 had ocular hypertension, 1 had glaucoma suspect and 2 had pigment dispersion glaucoma. Average IOP prior to stent insertion was 18.9. The average number of days after surgery for follow-up was 28.9.

Follow-up was arranged less than 2 weeks following procedure for 8 patients. The average change in IOP was an increase in 4.5. One patient had a pressure of 56 at 10 days post-op. Accounting for this, average IOP change at 2 weeks was a decrease of 3.

Of the patients reviewed at 2-6 weeks post op, the average change in IOP was a reduction of 2.1.

This real-world study demonstrates the benefit of innovative MIGs procedures showing a reduction of IOP in most patients at follow-up.