42 | EYEWORLD DAILY NEWS | JULY 25, 2021
ASCRS ANNUAL MEETING DAILY NEWS
The Hydrus Microstent (Ivan-
tis) is a highly biocompatible
nitinol stent that is contoured to
match the canal curvature, she
said in a recording of the pre-
sentation. There are three open
windows facing the anterior
chamber, and the canal-facing
surface is completely open for un-
obstructed access to the collector
channels.
This microstent has a trimod-
al mechanism of action. It spans
90 degrees where it dilates and
scaffolds open Schlemm's canal.
There's an inlet that provides a
larger opening through trabecular
meshwork and into Schlemm's
canal, she said.
The HORIZON trial is the
largest MIGS pivotal trial to date,
Dr. McCabe said, and it enrolled
556 patients over 38 sites in nine
countries. Patients were random-
ized to receive either cataract
surgery alone or in combination
with the Hydrus.
The 2-year data showed the
largest treatment effect of any
MIGS device with an IOP reduc-
tion of greater than or equal to
20%. The change in IOP was 2.3
mm Hg greater in the Hydrus
group, and medication-free pa-
tients were 78% at 2 years, a 30%
increase over cataract surgery
alone.
The primary endpoint assess-
ment at 2 years was washed out
IOP, but for practical reasons,
the endpoints at 5 years were
effectiveness based on being
medication-free, failure rates
(progression to surgery), or safety
findings (vision, endothelial cell
density, and adverse events).
Dr. McCabe said that 66%
of all Hydrus patients remained
medication-free at 5 years, which
was a 20–30% margin over
cataract surgery alone during that
period of time.
She said that 53% of patients
enrolled in the HORIZON trial
were on one medication at the
time of enrollment. Of the pa-
tients initially on one medication,
73% were on no medications at
5 years. IOP reduction was du-
rable over the 5-year period and
remained statistically significantly
better than cataract surgery alone.
A key finding of the 5-year
data, she said, was the reduced
risk of reoperations, including tra-
beculectomies, tube shunts, and
cilioablative procedures.
Safety data was consistent
over the 5-year period, with no
significant changes between 2 and
5 years.
Editors' note: Dr. McCabe has fi-
nancial interests with Ivantis.
continued from page 40
