Ultra-small drainage device may replace eye drop medications for some glaucoma patients

November 13, 2012

A tiny medical device no larger than an eyelash may significantly reduce eye pressure in glaucoma patients and allow some to stop using eye-drop medications, according to year-one clinical trial results for the device. Results of the HYDRUS I clinical trial, which indicate successful control of eye pressure in all study participants, will be presented today at the 116th Annual Meeting of the American Academy of Ophthalmology, jointly conducted this year with the Asia-Pacific Academy of Ophthalmology.

The Hydrus stent is one of several promising mini-drainage devices now in clinical trials in the United States and other countries. If future trials confirm micro-stents' effectiveness, they could someday help protect millions of from vision loss or blindness.

Open-angle glaucoma, the most common form of the disease, affects nearly three million people in the U.S and 60 million worldwide. (Click here to see how glaucoma can affect vision.) Though it is a multifactorial disease, currently the only proven way to prevent vision loss is by reducing (IOP). The treatment choices are effective but less than ideal, as some patients may not use eye drop medications consistently enough to control their IOP, while others simply don't respond to the drugs. Surgical procedures to open blocked drainage channels or implant larger stents, which are used only for patients with advanced glaucoma, carry risks of infection, bleeding, deterioration of other parts of the eye, and .

In this particular study of 69 patients suffering from mild to moderate open-angle glaucoma, IOP was reduced to acceptable levels in 100 percent of participants after they received minimally invasive stent implant surgery. In 40 patients the stent was placed during cataract surgery, a procedure that also reduces IOP. Twenty-nine patients had the Hydrus stent placed without cataract surgery to assess whether the stent would be effective on its own. No significant complications occurred in either patient group. At the six-month follow up, 85 percent of combined surgery and 70 percent of stent-only patients no longer needed eye drop medications to control their IOP. Reductions in IOP were consistent among all patients and remained stable at the one year follow up.

"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 Thomas W. Samuelson, M.D., a glaucoma specialist with Minnesota Eye Consultants, who served as the HYDRUS I trial's medical monitor. "If the devices can effectively control IOP over many years, it would be a real breakthrough in combating this blinding disease."

Dr. Samuelson cited the experience of an 81- year-old retired neurosurgeon who had tried multiple glaucoma medications, then had a drainage procedure called a trabeculoplasty, but couldn't achieve safe IOP levels. In 2010, the Hydrus was implanted in his right eye during cataract surgery, followed by the same surgery in his left eye a year later. A follow-up exam two months ago, confirmed that his IOP levels remained acceptably low in both eyes, without the use of eye drops.

A number of similar mini-stents, including the MIDI Arrow, Aquecentesis, and Transcend are now in development or clinical trials. The iStent was recently approved by the U.S. Food and Drug Administration for use in conjunction with . All of the stents work by providing a new drainage channel for the eye's aqueous fluid, circumventing the patient's own clogged or blocked channels. They vary in design, materials and implant site within the . Despite encouraging initial results, it will be several years before the long-term safety, efficacy and durability of this treatment approach can be fully confirmed.

Explore further: Glaucoma stent approved

Related Stories

Glaucoma stent approved

June 26, 2012
(HealthDay) -- An ocular stent that's designed to reduce inner-eye pressure among people with mild or moderate open-angle glaucoma has been approved by the U.S. Food and Drug Administration.

New research characterizes glaucoma as neurologic disorder rather than eye disease

March 7, 2012
A new paradigm to explain glaucoma is rapidly emerging, and it is generating brain-based treatment advances that may ultimately vanquish the disease known as the "sneak thief of sight." A review now available in Ophthalmology, ...

Research identifies risk factors associated with progression of glaucoma

May 9, 2011
Elevated pressure inside the eye, cornea thinning, and visual field loss are all markers that glaucoma may progress, according to a report in the May issue of Archives of Ophthalmology.

Home measurement of eye pressure in children may improve management of glaucoma

March 7, 2012
Measurement of pressure within the eye, or intraocular pressure (IOP), is known to fluctuate throughout the day, and wide swings in patients with glaucoma are believed to be related to the progression of the disease, which ...

Recommended for you

Simulations signal early success for fractal-based retinal implants

July 27, 2017
Computer simulations of electrical charges sent to retinal implants based on fractal geometry have University of Oregon researchers moving forward with their eyes focused on biological testing.

Scientists regenerate retinal cells in mice

July 26, 2017
Scientists have successfully regenerated cells in the retina of adult mice at the University of Washington School of Medicine in Seattle.

Genome editing with CRISPR-Cas9 prevents angiogenesis of the retina

July 24, 2017
A research team from the Schepens Eye Research Institute of Massachusetts Eye and Ear has successfully prevented mice from developing angiogenesis of the retina—the sensory tissue at the back of the eye—using gene-editing ...

Too little vitamin D may hinder recovery of injured corneas

July 24, 2017
Injury or disease in combination with too little vitamin D can be bad for the window to your eyes.

Combination of type 2 diabetes and sleep apnoea indicates eyesight loss within four years

July 4, 2017
Research led by the University of Birmingham has discovered that patients who suffer from both Type 2 diabetes and obstructive sleep apnoea are at greater risk of developing a condition that leads to blindness within an average ...

Nearly 60% of pinkeye patients receive antibiotic eye drops, but they're seldom necessary

June 28, 2017
A new study suggests that most people with acute conjunctivitis, or pinkeye, are getting the wrong treatment.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.