Trabecular Microbypass, Hydrus™ Microstent. Part 9 of 12 of “What’s New In Glaucoma Surgery” Presentation, a continuing education course for Optometrists presented by Patient-Focused Ophthalmologist, Dr. David Richardson on May 20, 2015.

Trabecular Microbypass, Hydrus™ Microstent

This here’s the Hydrus™ Microstent. What this does is it’s a stent the goes through here the Trabecular Meshwork and stents open the Schlemm’s canal for a number of clock hours. It’s about the size of an eyelash and it scaffolds it open. Unlike the istent, which just creates a little hole than just a little stent there. This is really stenting it open for a significant portion. Still, not as much as Canaloplasty but this is one of these things that can be done faster than Canaloplasty – ab-interno. So from within the eye rather through the sclera (ab-externo) and so for that reason it’s rather exciting.

Here we go, we can see here is the canal and notice that the canal already has blood in it. We know that there’s patency between the canal (Schlemm’s canal) and the collector channel system but glaucoma- in most cases open angle glaucoma, is due to a restriction here at the Trabecular Meshwork. So, what’s happening here— you can see this is probably a little bit more challenging to put in an iStent. This is a bigger device and you need to do is create that opening and then this device is just threaded into the canal and then the inserter is removed (again this is Dr. Ike Ahmed’s, out there in Canada and he and I have shared some mutual patients and I’d love to go up and see him operate one of these days. I just think he’s is a very elegant surgeon). What you see here is you could see this reflux of flood into the canal. It has this little windows here and so this is something that I would love to see here in the US because I think it would really take what we’ve got with the iStent and provide a significant extra benefit here in terms of how well it works. Now, let’s move on to the Suprachoroidal Implants.

08.16.2018 NEWS UPDATE: Hydrus microstent wins FDA approval. The FDA has approved the use of the Hydrus microstent in conjunction with cataract surgery to reduce IOP in patients with mild to moderate primary open-angle glaucoma. Source: https://bit.ly/2MX19sM

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