Hydrus Microstent

Abstract

The Hydrus®Microstent (Ivantis Inc., Irvine, CA, USA) is an 8-mm intracanalicular scaffold microinvasive glaucoma surgery (MIGS) device which reduces intraocular pressure (IOP) by bypassing the trabecular meshwork and by dilating and scaffolding the Schlemm’s canal. Indications for Hydrus Microstent implantation include primary open-angle glaucoma and pseudoexfoliation glaucoma and it can be implanted either in combination with cataract surgery or as a solo procedure. Studies have shown that the Hydrus Microstent lowers IOP to the mid-teens and reduces glaucoma medication use for up to 2 years. Hydrus Microstent implantation is associated with a favorable safety profile, with adverse effects being generally mild, transient, and self-resolving. Clinically significant and long-standing hypotony or other potentially sight-threatening complications have not been described so far with Hydrus Microstent implantation. This chapter summarizes the design, mechanism of action, surgical technique, and clinical outcomes of the Hydrus Microstent, which is a promising long-term treatment modality for patients with mild-to-moderate primary open-angle glaucoma.