A Fellow Eye Comparative Study of the Aquea Intracanalicular Glaucoma Micro-coil Stent and the Alcon Hydrus Glaucoma Microstent

Prior treatment

• Use of oral hypotensive medication treatment for glaucoma in the either eye.
• Significant risk by a washout of medication including those subjects with advanced glaucoma evidenced by an afferent pupillary defect, a C:D ratio ≥ 0.9 or encroachment of field loss within the central 5 degrees as indicated by ≥ 2 depressed points of 0.5% probability on the 24-2 SITA Standard Humphrey visual field.
• Previous glaucoma procedure with or without an implantable glaucoma device (with exception of laser treatments to the trabecular meshwork such as a Laser Trabeculoplasty performed more than three months prior to study enrollment).
• Previous surgery for retinal detachment.
• Previous corneal surgery, except for pterygium excision and corneal relaxing incisions.
• Clinically significant ocular inflammation or infection in either eye within thirty days prior to screening.
• Participation in any clinical trial within the 30 calendar days prior to Screening.

Other illness

• Diagnosis of acute angle closure, traumatic, congenital, malignant, uveitic, pseudoexfoliative, elevated episcleral venous pressure, pigmentary or neovascular glaucoma.
• Uncontrolled systemic disease that in the opinion of the Investigator would put the subject's health at risk and/or prevent the subject from completing all study visits.

Lab values

• Use of more than 3 ocular hypotensive medications. (Combination medications count as 2 or 3 medications depending on number of active ingredients.)

Age

• Wet age-related macular degeneration.

Other

• Proliferative or severe nonproliferative diabetic retinopathy.
• Central corneal thickness \> 620 microns.
• Clinically significant corneal dystrophy.
• Clinically significant ocular pathology, other than glaucoma.
• Best corrected visual acuity worse than 20/80 in either eye not attributable to cataract.
• Pregnant or nursing females. -

• Individuals 45 years of age or older, of either gender or any race, at the time of surgery.
• Able to understand the requirements of the study and willing to follow study instructions, provide written informed consent, and agree to comply with all study requirements, including the required study follow-up visits.
• A diagnosis of cataract eligible for phacoemulsification cataract extraction and IOL implantation.
• A diagnosis of primary open angle glaucoma (POAG) substantiated using funduscopic exam and/or at least one reliable visual field test (i.e., mean deviation \< 0 with fixation losses ≤ 30%, false positive errors ≤ 30% and false negative errors ≤ 30%) with the Humphrey automated perimeter using the SITA Standard 24-2 testing algorithm.
• At the Screening Visit, medicated IOP of ≤ 25 mmHg or unmedicated IOP of ≥ 21 mmHg and ≤ 33 mmHg.
• At the Baseline Visit, a mean unmedicated IOP of ≥ 21 mmHg and ≤ 33 mmHg. The mean will be derived from the diurnal IOP readings taken over the course of the Baseline Visit. Additionally, the baseline mean unmedicated diurnal IOP must be ≥ 3 mmHg higher than the medicated IOP measured at the Screening Visit.
• No changes in preoperative ocular hypotensive medication regimen for at least three months prior to Screening Visit.
• Gonioscopy confirming normal angle anatomy at site of implantation.
• Shaffer grade ≥ III in all four quadrants.
  • Intraoperative Inclusion Criteria
• Uncomplicated cataract extraction
• A well-centered posterior chamber IOL implanted in the capsular bag.
• A clear view of an open angle and visualization of the angle with direct gonioscopy post intracameral miotic instillation.