Three Migs Approaches, One Goal: A 2–3 Year Retrospective Comparison Of Elios, Istent, And Hydrus For Intraocular Pressure Reduction.”

To retrospectively compare the long-term clinical outcomes of three minimally invasive glaucoma surgery (MIGS) procedures—Elios excimer laser trabeculostomy, iStent trabecular micro-bypass implantation, and Hydrus microstent implantation—over a follow-up period of 2–3 years.

Single-center retrospective study conducted at a specialised Ophthalmology Center 

This retrospective cohort study included patients with mild to moderate primary open-angle glaucoma who underwent MIGS either as a standalone procedure or combined with cataract surgery. Patients were grouped according to the procedure performed (Elios, iStent, or Hydrus). Primary outcomes included intraocular pressure (IOP) reduction, change in the number of glaucoma medications, and surgical success at 24–36 months. Secondary outcomes included complication rates and the need for additional glaucoma interventions.

All three procedures demonstrated a significant reduction in IOP and medication burden during the follow-up period. Across the study population, Hydrus tended to achieve greater IOP reduction and medication decrease in some cohorts, while iStent demonstrated favorable safety profiles and low complication rates. 

Elios provided moderate pressure reduction with the advantage of being an implant-free procedure.

Elios, iStent, and Hydrus all provide effective and safe long-term IOP reduction in patients with mild to moderate glaucoma. While Hydrus may offer slightly greater pressure reduction in some cases, iStent and Elios remain valuable alternatives depending on anatomical considerations, safety profile, and surgeon preference. Further prospective studies are needed to better define the optimal patient selection for each MIGS technique.