SAFETY AND EFFICACY OF THE HYDRUS MICROSTENT DURING THE INITIAL LEARNING CURVE
Published 2025 - 29th ESCRS Winter Meeting
Reference: PP01.12 | Type: Free Paper | DOI: 10.82333/x2gg-rb51
Authors: Juan Lyn Ang* 1 , Sundeep Singh Deol 2 , Kelvin Cheng 1 , Tej Rane-Malcolm 1 , Mei-Ling Cheng 1 , Smrithy Sadanandan 1 , Su Ling Young 1 , Andrew Tatham 3
1Princess Alexandra Eye Pavilion,Edinburgh,United Kingdom, 2Kettering General Hospital NHS Foundation Trust,Edinburgh,United Kingdom;Princess Alexandra Eye Pavilion,Edinburgh,United Kingdom, 3Princess Alexandra Eye Pavilion,Edinburgh,United Kingdom;Centre of Clinical Brain Sciences,University of Edinburgh,Edinburgh,United Kingdom
Purpose
To examine the safety and efficacy of Hydrus Microstent during the learning curve of surgeons new to the procedure.
Setting
A single centre university hospital in the UK (Princess Alexandra Eye Pavilion, Edinburgh)
Methods
A retrospective study including a consecutive series of the first 38 Hydrus procedures performed by 3 surgeons. Two were experienced cataract and glaucoma surgeons with previous experience of MIGS but not Hydrus and one a glaucoma fellow. In 37 cases Hydrus was combined with cataract surgery. Patients were followed for a minimum of 3 months, with the primary outcomes percentage and absolute change in IOP at time of listing for surgery compared to the visit after and closest to 3 months post-op. The relationship between order of surgery and IOP reduction was examined using regression analyses.
Results
Mean baseline IOP was 20.5±6.5 mmHg (range 11-35mmHg), using an average of 2.0 topical medications. Average mean deviation (MD) was -9.9±7.4dB. Peak IOP prior to surgery was 26.3±5.8 mmHg. Average IOP at 3 months was 14.8±3.6 mmHg, significantly lower than baseline (P<0.001). 29 of 38 eyes (81.6%) had ≥20% reduction in IOP on the same or fewer medications. Average reduction in IOP was 23.3±27.1% (5.7±6.7 mmHg), with an average reduction of 1.4±1.2 medications. Eyes with higher baseline IOP had significantly greater IOP reduction (0.9, 95% CI 0.7 to 1.1 mmHg, greater IOP reduction per 1mmHg higher baseline IOP, P<0.001). Surgeon experience did not significantly influence efficacy. Two patients had transient hyphaema resolving by 1 week.
Conclusion
Surgeon experience during the initial learning curve for Hydrus had no apparent effect on efficacy or safety at 3 months. The study was limited by lack of corneal endothelial cell measurements however 5-year data from the HORIZON study indicated a high level of corneal safety even with long-term presence of the implant.