Hydrus microstent compared to selective laser trabeculoplasty in primary open angle glaucoma: one year results.
Fea Antonio M, Ahmed Iqbal Ike K, Lavia Carlo, Mittica Pietro, Consolandi Giulia, Motolese Ilaria, Pignata Giulia, Motolese Eduardo, Rolle Teresa, Frezzotti Paolo
AI Summary
This study compared Hydrus microstent to SLT for glaucoma. Hydrus significantly reduced medication dependence more than SLT at one year, offering a valuable option for patients seeking fewer eye drops.
Abstract
Background
To compare the reduction of intraocular pressure (IOP) and glaucoma medications following selective laser trabeculoplasty (SLT) versus stand-alone placement of the Hydrus microstent, a microinvasive glaucoma surgery device.
Design
Prospective interventional case-series. University practice.
Participants
Fifty six eyes (56 patients) with uncontrolled primary open-angle glaucoma.
Methods
Patients received either SLT (n = 25) or Hydrus implantation (n = 31) in two centres. Patients were evaluated at baseline and 1, 7 days, 1, 3, 6 and 12 months after surgery.
Main outcome measures
Intraocular pressure and number of glaucoma medications variations inter-groups and intra-groups.
Results
There were no significant differences at baseline between groups, but the mean deviation was worse in the Hydrus group (-8.43 ± 6.84 dB, confidence limits (CL)-2.8/-3.3 vs.-3.04 ± 0.65 dB, CL-6/-10.8; P < 0.001). After 12 months, there was a significant decrease in IOP and medications in the Hydrus group compared with baseline values. In the SLT group, only the decrease in IOP was significant. There was 3-fold greater reduction in medication use in the Hydrus group compared with SLT (-1.4 ± 0.97 vs.-0.5 ± 1.05, P = 0.001). 47% of patients were medication free at 12 months in the Hydrus group (4% in the SLT group). No complications were recorded in the SLT group. In the Hydrus group, three patients experienced a temporary reduction of visual acuity post-operatively, and two patients had post-operative IOP spikes that resolved within one week.
Conclusions
Both SLT and Hydrus implantation reduced IOP without serious adverse events. Hydrus implantation led to a significant and further reduction in medication dependence at 12 months.
MeSH Terms
Shields Classification
Key Concepts6
In a prospective interventional case-series of 56 eyes (56 patients) with uncontrolled primary open-angle glaucoma, Hydrus microstent implantation led to a significant decrease in intraocular pressure (IOP) and glaucoma medications compared with baseline values after 12 months.
In a prospective interventional case-series of 56 eyes (56 patients) with uncontrolled primary open-angle glaucoma, selective laser trabeculoplasty (SLT) led to a significant decrease in intraocular pressure (IOP) after 12 months, but not in glaucoma medications.
In a prospective interventional case-series of 56 eyes (56 patients) with uncontrolled primary open-angle glaucoma, there was a 3-fold greater reduction in medication use in the Hydrus microstent group compared with the selective laser trabeculoplasty (SLT) group after 12 months (-1.4 0.97 vs. -0.5 1.05, P = 0.001).
In a prospective interventional case-series of 56 eyes (56 patients) with uncontrolled primary open-angle glaucoma, 47% of patients in the Hydrus microstent group were medication-free at 12 months, compared to 4% in the selective laser trabeculoplasty (SLT) group.
In a prospective interventional case-series of 56 eyes (56 patients) with uncontrolled primary open-angle glaucoma, there were no significant differences at baseline between patients who received selective laser trabeculoplasty (n=25) or Hydrus microstent implantation (n=31), but the mean deviation was worse in the Hydrus group (-8.43 6.84 dB, confidence limits (CL)-2.8/-3.3 vs. -3.04 0.65 dB, CL-6/-10.8; P < 0.001).
In a prospective interventional case-series of 56 eyes (56 patients) with uncontrolled primary open-angle glaucoma, no complications were recorded in the selective laser trabeculoplasty (SLT) group, while in the Hydrus microstent group, three patients experienced a temporary reduction of visual acuity post-operatively, and two patients had post-operative intraocular pressure (IOP) spikes that resolved within one week.
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