Clinical Outcomes And Efficacy Of The Hydrus® Microstent In Patients With Pseudoexfoliative Glaucoma With A Follow-Up Of 2 Years

Pseudoexfoliative glaucoma (PEX) is the most common type of secondary open-angle glaucoma, its prevalence varies considerably across populations. There is only limited data available demonstrating the effectivity of Hydrus®Microstent for the treatment of PEX. We compare in this monocentric, retrospective, noninterventional observation the number of intraocular pressure (IOP)-lowering medications between the time before and up to 2 years after surgery.

This is a retrospective, monocentric, noninterventional observation. The surgical procedure was performed exclusively by two surgeons from Breyer Kaymak Klabe Augenchirurgie Düsseldorf, Germany. All evaluated follow-up observations were also performed in our practice.

The microstent was implanted in 68 eyes of 45 patients with early to moderate PEX-glaucoma during a combined surgery with a phacoemulsification and implantation of an intraocular lens. We monitored IOP, the number of glaucoma medications, visual acuity, visual field defects, and corneal endothelial cell density (ECD).

68 eyes were treated, of which 4 had undergone surgical and 7 SLT pretreatment. Preoperatively, IOP without washout was 20.5±5.4 mmHg. 1 and 2 years after surgery, IOP decreased to 14.5±1.7 mmHg 16.6±2.2 mmHg and, respectively. The mean number of IOP-lowering medication was reduced from 1.1±0.9 (72% with medication) to 0.25±0.7 (15%) and 0.1±0.3 (13%). The mean number of IOD-lowering medications in eyes with previous treatment decreased from 1.55±0.6 (100%) to 0.2±0.7 (12%) and 0.1±0.3 (8%), respectively. Visual acuity, visual field and ECD showed no clinically significant changes.

In patients with PEX, there is a clinically relevant difference in the number of IOP-lowering medications between the time before surgery and up to 2 years after implantation of at least 1 medication with simultaneous moderate pressure reduction. Compared to published data for cataract surgery standalone, combined surgery offers both a pressure-reducing effect and a reduction in medication intake over a longer period of time.