Hydrus Microstent Combined With Cataract Surgery In Pseudoexfoliation Glaucoma: Comparative Outcomes With Primary Open-Angle Glaucoma

Pseudoexfoliation glaucoma (PXG) is associated with higher intraocular pressure (IOP) levels and faster progression compared with primary open-angle glaucoma (POAG). Evidence on minimally invasive glaucoma surgery in PXG remains limited. This study evaluated the safety and efficacy of Hydrus Microstent implantation combined with cataract surgery in PXG and compared outcomes with POAG.

Single-center retrospective study at the Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.

Consecutive patients undergoing phacoemulsification combined with Hydrus Microstent implantation were retrospectively analysed. Primary outcomes were change in IOP and number of glaucoma medications from baseline to the last available follow-up up examination up to 14 months. Postoperative assessments were performed at day 1–2, week 1–4, week 4–6, month 3–4, month 4–6 and month 6-14. Outcomes were compared between PXG and POAG groups.

Fifty-three eyes were included (POAG n=33; PXG n=20). Mean baseline IOP was 16.5±4.7 mmHg in POAG and 19.2±5.5 mmHg in PXG (p=0.080). Baseline glaucoma medication use was 2.33±1.14 in POAG and 2.67±1.19 in PXG (p=0.338). Mean IOP reduction was −3.2±5.0 mmHg in POAG and −4.7±5.6 mmHg in PXG, with no significant intergroup difference (p=0.577). Medication reduction was −1.35±1.73 in POAG and −1.14±1.35 in PXG (p=0.750). No relevant between-group differences in baseline visual field pattern standard deviation were observed.

Hydrus Microstent implantation combined with cataract surgery provides comparable IOP and medication reduction in PXG and POAG. The procedure represents a safe and effective treatment option for patients with cataract and mild-to-moderate PXG.