Retrospective Analysis of 5-Year Outcomes with the Hydrus Microstent in Combination with Cataract Surgery

To evaluate the efficacy of the Hydrus microstent in conjunction with cataract surgery over a period of 5 years.

This was a retrospective, single site study. Eligible charts were from adults that had a diagnosis of mild to severe primary open angle glaucoma and underwent combined cataract surgery with Hydrus Microstent with a minimum of twelve months of follow-up data available. Outcome measures included mean number of ocular hypotensive medication prescribed, intraocular pressure, number of glaucoma secondary surgical interventions, corrected distance visual acuity, and visual field mean deviation.

A total of 280 eyes were identified that met the inclusion and exclusion criteria above. Mean medications improved from 2.3 ± 1.1 at baseline to 1.6 ± 1.3, 1.5 ± 1.3, 1.6 ± 1.3, 1.7 ± 1.4, and 2.5 ± 1.1 at 12, 24, 36, 48, and 60 months postoperatively, respectively. Intraocular pressure improved from 15.2 ± 4.1 mmHg at baseline to 12.8 ± 2.9 mmHg, 12.9 ± 2.8 mmHg, 13.0 ± 2.4 mmHg, 12.8 ± 3.1 mmHg, and 12.4 ± 2.5 mmHg at 12, 24, 36, 48, and 60 months postoperatively, respectively. Mean postoperative mean deviation was -3.8 ± 5.1, -3.9 ± 4.2, -2.9 ± 3.5, and -2.5 ± 3.6 dB at 12, 24, 36, and 48 months, respectively, compared to -5.4 ± 6.0 dB at baseline.

The results of this study suggest that after combination cataract and Hydrus Microstent surgery, the number of glaucoma medications and intraocular pressure are reduced, and visual fields are stable through 4 years postoperatively. Additional data collected at 5 years postoperatively suggest persistent medication and intraocular pressure reduction, though cautious interpretation is warranted given substantial patient attrition.