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September 16, 2019
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Positive effects of Hydrus plus phaco persist

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Gus Gazzard

PARIS — The HORIZON trial at 3 years demonstrated that the Hydrus Schlemm’s canal stent added sustained IOP lowering to that achieved by cataract surgery alone, Gus Gazzard, MD, MBBChir, FRCOphth, said at the European Society of Cataract and Refractive Surgeons meeting.

“That intraocular pressure was stable, significantly better than control after 3 years,” Gazzard said.

The positive effects of IOP lowering and need for fewer medications achieved in the 2-year HORIZON study persisted in the extension study, Gazzard said.

“There was a significant additional reduction in intraocular pressure and a significant reduction in the proportion of patients that were medication-free at 3 years’ outcome in this study,” Gazzard said.

The HORIZON study compared IOP lowering in patients with mild to moderate primary open-angle glaucoma undergoing phacoemulsification alone or combined with the Ivantis Hydrus microstent. The primary endpoint in the initial study was the reduction in washed-out IOP diurnal pressure at 24 months.

Freedom from medication achieved in the initial study was maintained at 3 years in the Hydrus group.

“The 2-year results are nearly replicated at 3 years, so it seems to be a persistent, durable pressure-lowering effect by the Hydrus stent; it’s not just an effect of the cataract surgery alone,” he said.

In the Hydrus arm, patients were at 85% lower risk for additional surgery at 3 years, according to the presentation, and there was no difference between the two arms with regard to average central corneal endothelial cell count. Other safety outcomes were comparable between the two groups, he said. – by Patricia Nale, ELS

Reference:

Gazzard G. The HORIZON trial: 3-year safety and efficacy outcomes of an international, prospective, multicenter, randomized study of a Schlemm’s canal microstent. Presented at: European Society of Cataract and Refractive Surgeons meeting; Sept. 13-18, 2019; Paris.

Disclosure: Gazzard reports he has financial disclosures with Alcon, Allergan, Bausch + Lomb, Ellex, Glaukos, Ivantis, Lumenis, Merck, Santen and Thea.