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Contralateral eye study investigates iStent vs Hydrus stent for glaucoma


At AAO 2022, Mitch Shultz, MD, provides discourse on iStent inject vs Hydrus contralateral eye evaluation data.

Video transcript

Note: This transcript has been lightly edited for clarity.

Mitch Shultz, MD: Hi, I'm Dr. Mitch Shultz from Los Angeles, California, and I'm here to talk to you a little bit today about the study that I've done on the iStent inject versus the Hydrus stent.

We've actually been looking now we're getting close to presenting 2-year data on this study where we implanted patients, contralateral eyes, 1 eye with iStent inject and 1 eye with Hydrus and have followed the patients prospectively over the last 2 years.

The interesting thing that's come out of this data has really been that both products work extremely well as far as target IOPs. Both products have achieved a significant reduction in patient eye drop load but we found in patients who are implanted with either stent with just the implants, they typically get off approximately 1 medication. What has been interesting is in combination with ab interno canaloplasty, we have actually been able to improve that to 1 and a half to 2 medication reduction in medication burden.
Another important fact has been the fact that 80% of patients have are now medication-free. So that's been another feature of the study.

But what has really been critical and what's really kind of changed. The way I'm doing things today is the fact that we have less adverse events in our iStent group than we've had in the Hydrus group. So what we've seen in the iStent group is zero intraoperative adverse events and zero postoperative adverse events.

Unfortunately, in the Hydrus group, there are some learning curve problems that surgeons may experience with underimplantations, overimplantations, or missing the passage and going into the superciliary space, which can lead to other problems postoperatively. We've actually seen one patient with angle closure glaucoma occur after Hydrus stent.

So I think when we're looking for safety, efficacy, iStent inject has really stood out in this group, even though both stents work very well. So thank you very much, and I look forward to seeing you around the meeting.

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