Last updated: October 2, 2026
The Hydrus Microstent is a small implant designed to improve drainage through Schlemm’s canal and reduce intraocular pressure. In the United States, current product information indicates it for use with cataract surgery in adults with mild to moderate primary open-angle glaucoma. It is not a universal first-line treatment and is not appropriate for every glaucoma type or eye anatomy.
Fichte, Endl & Elmer Eyecare may discuss Hydrus or another glaucoma procedure when the device’s current labeling, the patient’s angle anatomy, glaucoma severity, target pressure, cataract status, prior treatment, and overall eye health support that option. Device availability and the surgeon assigned to the procedure should be confirmed during the consultation.
How the Hydrus Microstent Works
The implant is placed through a small corneal incision and positioned within Schlemm’s canal. Its design is intended to bypass part of the trabecular meshwork, scaffold a portion of the canal, and improve access to collector channels. The treatment goal is to lower eye pressure and potentially reduce medication burden. It does not restore vision already lost to glaucoma and does not guarantee that drops or additional procedures will never be needed.
Who May Be Evaluated
Current United States product information identifies adults with mild to moderate primary open-angle glaucoma who are undergoing cataract surgery. Evaluation includes gonioscopy to examine the drainage angle, eye-pressure measurements, optic-nerve and visual-field assessment, cataract evaluation, review of prior glaucoma treatment, and discussion of the pressure goal for the individual eye.
When Hydrus Is Not Appropriate
Current product information lists angle-closure glaucoma and traumatic, malignant, uveitic, or neovascular glaucoma among the contraindications. Congenital abnormalities of the anterior chamber angle and conditions that prevent adequate visualization can also make implantation unsafe or inappropriate. The full instructions for use contain additional warnings and precautions.
Potential Risks and Limitations
Risks can include inflammation, bleeding in the front of the eye, pressure that remains too high or becomes too low, peripheral anterior synechiae, implant obstruction or malposition, corneal effects, infection, vision changes, and the need for medication or another procedure. The pivotal trial and current product information should be reviewed in the context of the patient’s own examination findings.
Hydrus Compared With Other Glaucoma Treatments
Hydrus is one of several treatment categories. Alternatives may include prescription drops, selective laser trabeculoplasty, OMNI canaloplasty and trabeculotomy, iStent, another minimally invasive glaucoma procedure, cataract surgery alone, XEN, trabeculectomy, or a glaucoma drainage implant. The expected amount of pressure lowering and follow-up burden differ across options.
Compare glaucoma drops, laser, MIGS, and traditional surgery.
Questions to Ask the Surgeon
- What type and stage of glaucoma do I have?
- Why is Hydrus being considered with my cataract surgery?
- What pressure reduction is a reasonable goal for my eye?
- Could I still need glaucoma drops afterward?
- What device-specific risks are most relevant to my anatomy?
- What follow-up is required, and which symptoms need an urgent call?
Schedule a Glaucoma Evaluation
Michael J. Endl, M.D., describes glaucoma procedure experience in his biography. Call 1-800-309-2020 or request an appointment to discuss currently available options.
Product and Patient Education Sources
This page provides general education and summarizes selected labeling concepts. The complete current instructions for use and an individual examination control treatment decisions.
