Micro-Stents a New Option for Glaucoma Patients

--by Jenara Nerenberg

The Gist

Glaucoma is a debilitating disease that causes blindness in advanced cases, but surprisingly, the only treatment currently available is eye drops to help control intra-ocular pressure (IOP) in the eyes. But a recent clinical trial involving micro-stents, which help to reduce pressure by draining fluid from patients' eyes, is proving highly effective at controlling pressure in the eyes without the use of eye drops.

The results of the HYDRUS 1 year-long clinical trial are being presented today at the 116th Annual Meeting of the American Academy of Ophthalmology. The results of the trial show that 70 to 85 percent of participants no longer needed eye drops six months after the stent was implanted in the eye. The findings are encouraging because patients often struggle with consistent use of the drops, and for some, the drops are not helpful. 

The Expert Take

"So far, mini-stents appear to have important advantages in that they allow us to treat open-angle glaucoma at earlier stages and with lower complication risk," said lead investigator and glaucoma specialist Dr. Thomas W. Samuelson.

Corrective surgeries used to drain fluid in advanced cases of glaucoma present several risks, including infection and bleeding, which can cause blindness. As such, alternatives are in high demand and eagerly sought by patients and physicians alike.

"If the devices can effectively control IOP over many years, it would be a real breakthrough in combating this blinding disease," Samuelson said.

The Takeaway

The first step in preventing glaucoma is to get regular, yearly eye checkups, especially if the disease runs in your family. You may not show any signs of the disease, and when you do, it's normally too late to prevent ensuing vision impairment. Early detection is critical, and if the micro-stents from the HYDRUS I trial are approved by government bodies in a few years, the option may be of interest to you.

Source and Method

Sixty-nine patients participated in the study—40 received the standalone stent and 29 received the stent during surgery to correct a cataract—and the eye pressure of all participants was reduced to manageable levels as a result. Interestingly, whereas 70 percent of the stent-only participants no longer required eye drops after six months, 85 percent who received the combined stent and cataract surgery no longer required drops six months later. 

Other Research

A 2007 study evaluating the effectiveness of a micro-bypass stent also showed that eye pressure was significantly reduced and that complications were fewer as compared to other treatment options. Another micro-bypass stent study on a device called iStent showed the same findings, indicating that stent-based procedures may be viable for sustainably managing eye pressure in some glaucoma patients.

However, a study released this year indicates that less invasive options, such as laser-based phacoemulsification—called a "micro-invasive" procedure—should remain a prominent option for glaucoma patients, and that all procedures should be evaluated in light of their risks and benefits.