A Schlemm’s canal scaffold for the treatment of elevated IOP

Introduction: In the age of micro invasive /minimally invasive glaucoma surgery (MIGS), numerous glaucoma drainage devices are gaining importance. Hydrus is the latest device undergoing FDA approved clinical trials and is showing promising results in terms of intraocular pressure reduction in mild to moderate glaucoma when combined with cataract surgery.Areas covered: This review provides a detailed discussion of the preclinical and clinical trials of the Hydrus Microstent. A brief description of other new Schlemm’s canal based surgical procedures is also provided. An extensive literature search was made using the following keywords; Hydrus, Microstent, Schlemm’s canal scaffold, MIGS and outflow facility. Information on active clinical trials was obtained from clinicaltrails.gov. Recent and ongoing research activities on MIGS were obtained from abstracts presented at ARVO and AAO in recent years.Expert commentary: Hydrus microstent bypasses the trabecular meshwork and dilates a part of the Schlemm’s canal providing the aqueous humor with better access to collector channels and other downstream drainage vessels. Current and pending clinical trials will provide the long term safety and IOP efficacy of the Microstent. Only the future will determine whether MIGS will replace topical medications and lasers as a first line treatment option in glaucoma treatment.