Hydrus Minimally Invasive Glaucoma Surgery (MIGS)

This minimally invasive technique, the Hydrus stent is highly effective in reducing pressure in those with glaucoma.

The technique has been shown in studies to reduce the need for taking glaucoma drops and the majority of patients are off drops altogether.

The technique can be combined with cataract surgery eliminating the need for more than one procedure.

What is Hydrus™?

The Hydrus™ Microstent, is roughly the size of an eyelash and is made of Nitinol, an alloy used in many medical implants.

Developed by the company Ivantis the device has been well researched and found to be highly effective in reducing intraocular pressure (IOP).

How does it work?

A block somewhere in the drainage system stops fluid from entering Schlemm’s canal – an important drainage channel that directs fluid out of the eye and into collector vessels on the surface of the eye.

The Hydrus implant allows escape of the aqueous fluid in the eye to bypass the normal trabecular meshwork (which is where the block is likely to be).  Through a microscopic incision, the device is implanted into Schlemm’s canal.

Very much like a coronary artery stent, it keeps Schlemm’s canal open and prevents it from collapsing and the length of the device is sufficiently long to be effective. The technique is often combined with cataract surgery using the same microscopic incisions.

What are the Outcomes like?

Over 2000 procedures have been performed as part of clinical studies or global registries.

In addition to the HYDRUS II and HYDRUS IV trials, the Hydrus technology is also being studied internationally in both cataract and stand-alone glaucoma surgery settings in various types and severities of glaucoma.

According to the study presented at the XXIX Congress of the ESCRS, it is effective at lowering intraocular pressure and reduces the need for medications in patients with primary open angle glaucoma (POAG).

Enhancing outcomes

An option to enhance aqueous outflow and reduce pressure further can be achieved by opening the 3 windows on the Hydrus by using a Nd: YAG laser.

Early European studies (on file with Ivantis, Inc.) have shown a dramatic reduction of eye pressure.

Author Information

Authored by Sheraz Daya MD FACP FACS FRCS(Ed) FRCOphth, Consultant Ophthalmic Surgeon & Medical Director, June 2019.

Next review due June 2024.

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