Impact of combined Hydrus Microstent implantation and cataract surgery on diurnal intraocular pressure range: a longitudinal, retrospective study

Abstract

Abstract Purpose To evaluate the impact of combined Hydrus Microstent implantation and cataract surgery on the 24-hour intraocular pressure (IOP) range in patients with open-angle glaucoma. Patients and methods This retrospective, single-center study included 125 consecutive eyes of 125 patients who underwent combined Hydrus Microstent implantation and cataract surgery. Inpatient 24-hour IOP profiles (comprising daytime Goldmann applanation tonometry and nocturnal iCare rebound tonometry) from before and after surgery were analyzed. Surgical success was defined as a postoperative mean 24-hour IOP ≤ 21 mmHg with either a ≥ 20% reduction from baseline or a reduction in glaucoma medication burden. The primary outcome measures were changes in mean 24-hour IOP, maximum 24-hour IOP, and 24-hour IOP range (defined as the difference between the maximal and minimal 24-hour IOP). Results Mean preoperative 24-hour IOP of 21.0 ± 5.5 mmHg decreased to 16.5 ± 4.0 mmHg postoperatively (mean reduction: 4.5 mmHg) at a mean follow-up of 76 days (range 7–338 days; median 61 days; IQR 35–91). The 24-hour IOP range significantly decreased from 10.7 ± 6.5 mmHg to 7.7 ± 4.0 mmHg ( p < 0.001), and mean maximum 24-hour IOP decreased by 6.2 ± 5.4 mmHg. The number of glaucoma medications was reduced from 2.4 ± 1.2 to 0.6 ± 1.1, with 74.4% of patients becoming medication-free. Overall surgical success was achieved in 88.0% of patients. Conclusion Combined Hydrus Microstent implantation and cataract surgery significantly reduced glaucoma medication burden and effectively decreased 24-hour IOP range and pressure spikes. Précis Combined Hydrus Microstent implantation with cataract surgery reduced diurnal intraocular pressure range and pressure peaks while lowering mean intraocular pressure, indicating improved pressure stability beyond average reduction alone.