Abstract
Purpose :
The addition of Hydrus Microstent during OMNI Canaloplasty (OMNI) during cataract surgery (CS) may be beneficial for sustained schlemms canal scaffolding and confirmation dilation, yet it poses potential concerns such as hyphema, device misplacement, and uncertain endothelial cell effects.1-4 This study compares the 1-year efficacy of performing OMNI with or without Hydrus Microstent (OMNI/Hydrus) in patients with glaucoma.
Methods :
A retrospective analysis was performed on 72 eyes (mean age 71.8 ± 11.1 years). During CS, 36 eyes received OMNI and 36 received OMNI/Hydrus. Patients who had prior glaucoma or laser procedures were included. The mean number of ocular hypotensive medications and intraocular pressure (IOP) were recorded at baseline and 1 year. The primary outcome was surgical success, defined as attaining the target IOP at 1 year without additional medications or procedures. Eyes were matched (1:1) based on preoperative demographics, baseline and target IOP, baseline medication number, and if target IOP was met at baseline. Few imbalances in glaucoma type and race remained. Chi-squared and indepdendent and paired t-tests were performed.
Results :
The majority of patients had mild, primary-open angle glaucoma [Table 1]. The OMNI group showed a greater reduction in mean IOP (22.9% OMNI vs. 3.2% OMNI/Hydrus) while the OMNI/Hydrus group showed greater reduction in medication use (45.3% OMNI vs. 63.4% OMNI/Hydrus) [Table 2]. Surgical success rates were 69.4% for OMNI and 55.6% for OMNI/Hydrus (p>0.05). At 1 year, 58.3% of OMNI and 69.4% of OMNI/Hydrus patients were medication-free (p>0.05). Adverse events all occurred >1 month postoperatively and included steroid response (2 OMNI), hyperemia (2 OMNI), persistent corneal edema (2 OMNI/Hydrus), and iridodialysis (1 OMNI/Hydrus). No eyes received secondary surgical intervention.
Conclusions :
Both OMNI and OMNI/Hydrus during CS effectively reduce IOP and lessen medication reliance after 1 year. Although addition of the Hydrus Microstent showed a greater reduction in medications, the overall efficacy of achieving surgical success appears similar to success rates of OMNI alone. This underscores the importance of considering individual patient characteristics, such as disease severity and baseline medication load, in tailoring surgical interventions for optimal glaucoma management.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.