Racial Differences in Outcomes in Hydrus Microstent with Phacoemulsification in Primary Open Angle Glaucoma

Abstract

Purpose : While the effectiveness of the Hydrus Microstent is well-documented, there is limited data on its performance across different racial groups.1,2 This study addresses this gap by comparing the outcomes of this treatment in White not Hispanic and Black patients with primary open angle glaucoma (POAG), aiming to enhance our understanding of racial disparities in glaucoma management.

Methods : A retrospective analysis was performed on mild-to-moderate POAG patients who underwent Hydrus Microstent with phacoemulsification. Patients with prior glaucoma procedures or laser were included. The mean number of ocular hypotensive medications and intraocular pressure (IOP) were assessed preoperatively and postoperatively at 12 months. Complications and secondary surgical interventions were recorded. The primary outcome was surgical success, defined as attaining the target IOP at 12-month without additional medication or glaucoma procedure. Eyes were matched (1:1) based on baseline demographics, baseline and target IOP, baseline number of medications, and if target IOP was met at baseline. Statistical analysis included a chi-squared and independent and paired t-test.

Results : In our 134-eye cohort (67 white not hispanic, 67 black), the mean age was 71.5 ± 8.3 years. Mean baseline IOP for the white not hispanic and black group was 16.4 ± 4.8 mmHg and 15.9 ± 5.2 mmHg, respectively. Mean baseline medications were 2.16 ± 1.07 and 2.09 ± 1.16 for the white not hispanic and black group, respectively. Mean IOP at 12 months was 14.3 mmHg ± 3.2 (13.2% reduction; p<0.05) for the white cohort and 14.3 mmHg ± 4.3 (10.3% reduction; p<0.05) for the black cohort. Mean medications at one year were 1.13 ± 1.15 (47.6% reduction; p<0.001) for the white cohort and 1.06 ± 1.25 (49.3% reduction; p<0.001) for the black cohort. Surgical success was achieved at 12 months in 55.2% (37/67) of the white cohort and 59.7% (40/67) of the black cohort (p>0.05 between groups). At 12 months, 41.8% of white not hispanic and 49.3% of black patients were medication-free (p>0.05).

Conclusions : Hydrus Microstent combined with phacoemulsification effectively reduces IOP and medication dependency in both White not Hispanic and Black POAG patients, with comparable surgical success rates. A long-term randomized controlled trial is warranted to validate these findings across diverse populations.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.