{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T03:17:21Z","timestamp":1790392641616,"version":"4.1.0"},"reference-count":25,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2025,8,4]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To compare the long-term effectiveness of combined phacoemulsification and Hydrus microstent (phaco-Hydrus) versus iStent inject (phaco-iStent) using microinvasive glaucoma surgery-specific surgical success definitions in a large observational cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective study of eyes in the Fight Glaucoma Blindness registry that underwent phaco-Hydrus or phaco-iStent with a minimum of 48\u2009months follow-up. The prespecified primary endpoint was \u226520%\u2009intraocular pressure (IOP) decrease and IOP \u226421\u2009mm Hg or \u22651 medication reduction versus baseline at 48 months with no preoperative washout. Propensity score matching of baseline covariates was used to examine outcomes in a subcohort (matched cohort).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>431 eyes (98 phaco-Hydrus: 331 phaco-iStent) were included in the overall cohort and 177 eyes (59 phaco-Hydrus: 118 phaco-iStent) in the matched cohort. There was no significant difference in the rate of surgical success between each group in achieving the primary endpoint at 48 months (adjusted overall cohort, 41.2% vs 43.0% in phaco-Hydrus vs phaco-iStent respectively, p=0.81; matched cohort, 44.1% vs 43.2%, p=0.99). There was no significant difference in degree of IOP reduction, medication reduction and adjusted secondary outcomes between the phaco-Hydrus and phaco-iStent groups in both overall and matched cohorts. The incidence of adverse events and secondary procedures was similar between both groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There was no significant difference in surgical success between phaco-Hydrus and phaco-iStent groups at 48 months. Over 40% of eyes maintained the primary success endpoint of \u226520%\u2009IOP decrease and IOP \u226421\u2009mm Hg or \u22651 medication reduction versus baseline without the need for secondary glaucoma surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjo-2025-327359","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T01:50:18Z","timestamp":1755654618000},"page":"52-58","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Long-term comparative outcomes of Hydrus versus iStent inject microinvasive glaucoma surgery implants combined with cataract surgery"],"prefix":"10.1136","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4117-7446","authenticated-orcid":false,"given":"Jeremy C K","family":"Tan","sequence":"first","affiliation":[{"name":"The University of Sydney Save Sight Institute, Sydney, New South Wales, Australia"},{"name":"Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia"},{"name":"Ophthalmology, Prince of Wales Hospital and Community Health Services, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1484-2615","authenticated-orcid":false,"given":"Colin","family":"Clement","sequence":"additional","affiliation":[{"name":"The University of Sydney Save Sight Institute, Sydney, New South Wales, Australia"},{"name":"Glaucoma Unit, Sydney Hospital and Sydney Eye Hospital, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Healey","sequence":"additional","affiliation":[{"name":"The University of Sydney Save Sight Institute, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ridia","family":"Lim","sequence":"additional","affiliation":[{"name":"Glaucoma Unit, Sydney Hospital and Sydney Eye Hospital, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6931-5797","authenticated-orcid":false,"given":"Andrew","family":"White","sequence":"additional","affiliation":[{"name":"Centre for Vision Research, Westmead Institute for Medical Research, Westmead, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Yuen","sequence":"additional","affiliation":[{"name":"Applecross Eye Clinic, Ardross, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish","family":"Agar","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia"},{"name":"Ophthalmology, Prince of Wales Hospital and Community Health Services, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7600-2534","authenticated-orcid":false,"given":"Mitchell","family":"Lawlor","sequence":"additional","affiliation":[{"name":"The University of Sydney Save Sight Institute, Sydney, New South Wales, Australia"},{"name":"Glaucoma Unit, Sydney Hospital and Sydney Eye Hospital, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,8,19]]},"reference":[{"key":"2025121502150586000_110.1.52.1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ogla.2019.12.003","article-title":"American Glaucoma Society Position Paper: Microinvasive Glaucoma Surgery","volume":"3","author":"Fellman","year":"2020","journal-title":"Ophthalmol Glaucoma"},{"key":"2025121502150586000_110.1.52.2","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.ajo.2023.02.008","article-title":"Five-Year Visual Field Outcomes of the HORIZON Trial","volume":"251","author":"Montesano","year":"2023","journal-title":"Am J Ophthalmol"},{"key":"2025121502150586000_110.1.52.3","doi-asserted-by":"crossref","DOI":"10.1136\/bmjophth-2023-001575","article-title":"Rates of visual field change and functional progression in glaucoma following trabecular microbypass implantation of iStent technologies: a meta-analysis","volume":"9","author":"Gillmann","year":"2024","journal-title":"BMJ Open Ophthalmol"},{"key":"2025121502150586000_110.1.52.4","article-title":"Ab interno trabecular bypass surgery with Schlemm\u2032s canal microstent (Hydrus) for open angle glaucoma","volume":"3","author":"Otarola","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"2025121502150586000_110.1.52.5","article-title":"Ab interno trabecular bypass surgery with iStent for open-angle glaucoma","volume":"3","author":"Le","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"2025121502150586000_110.1.52.6","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.2147\/OPTH.S403386","article-title":"Comparison of Efficacy of Combined Phacoemulsification and iStent Inject versus Combined Phacoemulsification and Hydrus Microstent","volume":"17","author":"Chee","year":"2023","journal-title":"Clin Ophthalmol"},{"key":"2025121502150586000_110.1.52.7","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph20054152","article-title":"Comparison of Safety and Efficacy of Hydrus and iStent Combined with Phacoemulsyfication in Open Angle Glaucoma Patients: 24-Month Follow-Up","volume":"20","author":"Jab\u0142o\u0144ska","year":"2023","journal-title":"Int J Environ Res Public Health"},{"key":"2025121502150586000_110.1.52.8","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.ophtha.2024.07.030","article-title":"Special Commentary: Reporting Clinical Endpoints in Studies of Minimally Invasive Glaucoma Surgery","volume":"132","author":"Gedde","year":"2025","journal-title":"Ophthalmology"},{"key":"2025121502150586000_110.1.52.9","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/j.ophtha.2018.12.030","article-title":"Clinical Registries in Ophthalmology","volume":"126","author":"Tan","year":"2019","journal-title":"Ophthalmology"},{"key":"2025121502150586000_110.1.52.10","doi-asserted-by":"crossref","DOI":"10.1186\/s13023-024-03193-y","article-title":"Scoping review of the recommendations and guidance for improving the quality of rare disease registries","volume":"19","author":"Tarride","year":"2024","journal-title":"Orphanet J Rare Dis"},{"key":"2025121502150586000_110.1.52.11","doi-asserted-by":"crossref","DOI":"10.1136\/bmjophth-2021-000903","article-title":"Efficient capture of high-quality real-world data on treatments for glaucoma: the Fight Glaucoma Blindness! Registry","volume":"6","author":"Lawlor","year":"2021","journal-title":"BMJ Open Ophthalmol"},{"key":"2025121502150586000_110.1.52.12","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1111\/ceo.14048","article-title":"Comparative study of 2-year outcomes for Hydrus or iStent inject microinvasive glaucoma surgery implants with cataract surgery","volume":"50","author":"Holmes","year":"2022","journal-title":"Clin Exp Ophthalmol"},{"key":"2025121502150586000_110.1.52.13","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1016\/j.ogla.2024.07.002","article-title":"Outcomes and Baseline Predictors of Failure in Primary Standalone Xen45 Gel Stent versus Trabeculectomy for Glaucoma","volume":"7","author":"Tan","year":"2024","journal-title":"Ophthalmol Glaucoma"},{"key":"2025121502150586000_110.1.52.14","doi-asserted-by":"crossref","first-page":"100108","DOI":"10.1016\/j.ajoint.2025.100108","article-title":"Visual rehabilitation in subconjunctival MIGS versus trabeculectomy and tube shunt surgery","volume":"2","author":"Tan","year":"2025","journal-title":"AJO International"},{"key":"2025121502150586000_110.1.52.15","unstructured":"Heuer D , Barton K , Grehn F , et al . Consensus on definitions of success. Kugler Publications, 2018:15\u201324."},{"key":"2025121502150586000_110.1.52.16","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2021.2351"},{"key":"2025121502150586000_110.1.52.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2019.04.034"},{"key":"2025121502150586000_110.1.52.18","doi-asserted-by":"crossref","first-page":"3307","DOI":"10.1007\/s40123-023-00819-5","article-title":"Comparative Effectiveness and Safety of Two Different Trabecular MIGS Devices With and Without Ab Interno Canaloplasty in Patients with Primary Open-Angle Glaucoma","volume":"12","author":"Shultz","year":"2023","journal-title":"Ophthalmol Ther"},{"key":"2025121502150586000_110.1.52.19","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1016\/j.ophtha.2022.02.021","article-title":"Long-term Outcomes from the HORIZON Randomized Trial for a Schlemm\u2019s Canal Microstent in Combination Cataract and Glaucoma Surgery","volume":"129","author":"Ahmed","year":"2022","journal-title":"Ophthalmology"},{"key":"2025121502150586000_110.1.52.20","doi-asserted-by":"crossref","first-page":"5171","DOI":"10.3390\/jcm12165171","article-title":"Position of the ISTENT Inject\u00ae Trabecular Micro-Bypass System Visualized with the NIDEK GS-1 Gonioscope\u2014A Postoperative Analysis","volume":"12","author":"Zimmermann","year":"2023","journal-title":"JCM"},{"key":"2025121502150586000_110.1.52.21","doi-asserted-by":"crossref","DOI":"10.1016\/j.xops.2024.100604","article-title":"Visualization of Scleral Flap Patency in Glaucoma Filtering Blebs Using OCT","volume":"5","author":"Tan","year":"2025","journal-title":"Ophthalmol Sci"},{"key":"2025121502150586000_110.1.52.22","doi-asserted-by":"crossref","DOI":"10.1186\/s12886-024-03770-6","article-title":"Discriminatory power of trabeculectomy bleb internal reflectivity and morphology in surgical success using anterior segment optical coherence tomography","volume":"25","author":"Tan","year":"2025","journal-title":"BMC Ophthalmol"},{"key":"2025121502150586000_110.1.52.23","doi-asserted-by":"crossref","DOI":"10.3390\/bioengineering10101186","article-title":"Swept-Source Anterior Segment Optical Coherence Tomography Imaging and Quantification of Bleb Parameters in Glaucoma Filtration Surgery","volume":"10","author":"Tan","year":"2023","journal-title":"Bioengineering (Basel)"},{"key":"2025121502150586000_110.1.52.24","doi-asserted-by":"publisher","DOI":"10.1097\/ICU.0b013e3282f3919b"},{"key":"2025121502150586000_110.1.52.25","doi-asserted-by":"publisher","DOI":"10.1001\/archophthalmol.2011.117"}],"container-title":["British Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bjo-2025-327359","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T10:15:58Z","timestamp":1765793758000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjo.bmj.com\/lookup\/doi\/10.1136\/bjo-2025-327359"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,19]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12,15]]},"published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1136\/bjo-2025-327359"],"URL":"https:\/\/doi.org\/10.1136\/bjo-2025-327359","relation":{},"ISSN":["0007-1161","1468-2079"],"issn-type":[{"value":"0007-1161","type":"print"},{"value":"1468-2079","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,19]]}}}