The Hydrus Microstent is a small medical device designed to manage intraocular pressure within the eye. This device represents an advancement in glaucoma treatment, offering a less invasive option for certain individuals. Its primary purpose is to address high intraocular pressure, aiming to preserve vision. The microstent is engineered to work within the eye’s natural drainage system.
Targeting Glaucoma
Glaucoma refers to a group of eye diseases that can damage the optic nerve, often due to elevated intraocular pressure. This increase in pressure, known as IOP, occurs when fluid within the eye does not drain properly. Over time, sustained high IOP can lead to irreversible vision loss and, if left untreated, blindness. The most common form is primary open-angle glaucoma (POAG), where the eye’s drainage system becomes less efficient, even though the drainage angle appears open. Managing IOP is a goal in glaucoma care to prevent further optic nerve damage.
How It Works
The Hydrus Microstent functions by improving the eye’s natural fluid drainage system. The eye continuously produces a fluid called aqueous humor, which nourishes the eye and then drains away. In glaucoma, this drainage can be impaired, leading to fluid buildup and increased pressure. The Hydrus Microstent, a flexible device roughly the size of an eyelash, is made of nitinol, a biocompatible nickel-titanium alloy.
This microstent is placed within Schlemm’s canal, a circular drainage channel in the eye. Its design allows it to bypass the trabecular meshwork, which can be a primary site of resistance to fluid outflow in glaucoma. By scaffolding and dilating approximately three clock hours, or 90 degrees, of Schlemm’s canal, the device enhances the flow of aqueous humor. This improved drainage helps to reduce and control intraocular pressure.
The Implantation Process
Implanting the Hydrus Microstent is a minimally invasive glaucoma surgery (MIGS) procedure. It is frequently performed in conjunction with cataract surgery, utilizing the same small corneal incision already made for cataract removal. This combined approach means no additional incisions are necessary. The procedure is an outpatient one, conducted under local anesthesia with some sedation.
During the procedure, the surgeon uses a specialized delivery system to insert the microstent through the corneal incision. The device is then positioned within Schlemm’s canal. The aim is to ensure proper placement for effective fluid drainage. The entire implantation process is quick, contributing to a faster recovery compared to more traditional glaucoma surgeries.
Patient Suitability and Expectations
The Hydrus Microstent is suitable for adult patients diagnosed with mild to moderate primary open-angle glaucoma. This is particularly relevant for those also undergoing cataract surgery. However, it is not appropriate for all types of glaucoma, such as angle closure, traumatic, or neovascular glaucoma. A thorough evaluation by an eye care professional determines individual suitability.
Patients can expect a reduction in their intraocular pressure following the procedure. Many individuals may also experience a decrease in their reliance on daily glaucoma eye drops, with some able to stop using them altogether. Clinical studies have shown significant pressure lowering, with a sustained reduction observed for several months post-operation.
In the immediate period after surgery, some blurriness, discomfort, light sensitivity, or mild bleeding in the eye may occur. Post-operative care involves using prescribed eye drops, such as steroids, for several weeks to aid healing. While initial vision improvement can take a week or two, the microstent remains in the eye permanently and is neither seen nor felt by the patient. Regular follow-up appointments are important to monitor eye pressure and overall eye health.