title: Hydrus microstent compared to selective laser trabeculoplasty in primary open angle glaucoma: one year results.
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.
  
  
  METHODS
  Prospective interventional case-series. University practice.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
authors.affiliation: Department of Surgical Sciences, University of Turin, Ophthalmologic Unit, Turin, Italy.
authors.forename: Antonio M
authors.initials: AM
authors.lastname: Fea
authors.affiliation: Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Iqbal Ike K
authors.initials: II
authors.lastname: Ahmed
authors.affiliation: Department of Surgical Sciences, University of Turin, Ophthalmologic Unit, Turin, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Lavia
authors.affiliation: Department of Medical, Surgical and Neuroscience, University of Siena, Santa Maria alle Scotte Hospital, Siena, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Mittica
authors.affiliation: Department of Surgical Sciences, University of Turin, Ophthalmologic Unit, Turin, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Consolandi
authors.affiliation: Department of Medical, Surgical and Neuroscience, University of Siena, Santa Maria alle Scotte Hospital, Siena, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Motolese
authors.affiliation: Department of Surgical Sciences, University of Turin, Ophthalmologic Unit, Turin, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Pignata
authors.affiliation: Department of Medical, Surgical and Neuroscience, University of Siena, Santa Maria alle Scotte Hospital, Siena, Italy.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Motolese
authors.affiliation: Department of Surgical Sciences, University of Turin, Ophthalmologic Unit, Turin, Italy.
authors.forename: Teresa
authors.initials: T
authors.lastname: Rolle
authors.affiliation: Department of Medical, Surgical and Neuroscience, University of Siena, Santa Maria alle Scotte Hospital, Siena, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Frezzotti
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D020327:Glaucoma Drainage Implants; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008904:Miniaturization; D011446:Prospective Studies; D011474:Prosthesis Design; D015607:Stents; D013997:Time Factors; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity
keywords: Hydrus; SLT; glaucoma; minimally invasive glaucoma surgery; trabecular surgery