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Changes in intraocular pressure (IOP), anti-glaucoma medications and visual acuity, and rates of complications including hyphema, peripheral anterior synechiae and significant IOP elevation, defined as \u2265 30\u00a0mmHg or an increase of \u2265 6\u00a0mmHg from preoperative IOP, were recorded. IOP outcome criteria and surgical success were reported per European Glaucoma Society and American Academy of Ophthalmology (AAO) guidelines, respectively. Linear mixed models were used for continuous variables, logistic regression for categorical variables and cluster-adjusted Cox regression to compare survival between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Two hundred and fifty-two eyes of 207 subjects across three centers were studied. One hundred and twenty-eight eyes received iStent inject and 124 received Hydrus microstent; 96.1% of iStent and 100% of Hydrus eyes underwent combined phacoemulsification. At 24\u00a0months postoperatively, \u2265 20% IOP reduction with anti-glaucoma medications (AGMs) was achieved by 35.8% (Hydrus) or 30.0% (iStent); or without AGM 13.4% (Hydrus) or 6.67% (iStent). Drop-freedom was achieved by 48.7% (Hydrus) or 38.5% (iStent). An IOP of \u2264 15\u00a0mmHg with AGM was achieved by 55.2% (Hydrus) or 63.3% (iStent); or without AGM 28.4% (Hydrus) or 21.7% (iStent). The 12-month cumulative risk of failure to maintain \u2265 20% IOP reduction with AGM was 86.7% (Hydrus) or 90.3% (iStent); or without AGM 90.1% (Hydrus) or 92.5% (iStent). Surgical success based on AAO guidelines was attained by 60.5% (Hydrus) or 53.8% (iStent) of eyes. Significant IOP elevation was the most common complication (4.84% Hydrus; 4.54% iStent), followed by hyphema (0.8% Hydrus; 4.5% iStent) at 1\u00a0month postoperatively. Outcomes did not differ significantly between the Hydrus and iStent groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Both iStent inject and Hydrus microstent achieved modest IOP-lowering efficacy and low complication rates in HM eyes. Neither device exceeded the minimal clinically important difference proposed for MIGS combined with cataract surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40662-026-00512-1","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T01:07:06Z","timestamp":1790644026000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical outcomes of trabecular micro-bypass minimally invasive glaucoma surgery devices in eyes with high myopia: a 24-month retrospective multicenter cohort study"],"prefix":"10.1186","volume":"13","author":[{"given":"Bryan Chin Hou","family":"Ang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie Shi Qi","family":"Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditi","family":"Kochar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Lor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee Ching","family":"Phang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hla Myint","family":"Htoon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell","family":"Lawlor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prasanna Venkatesh","family":"Ramesh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Younhea","family":"Jung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhu Li","family":"Yap","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Si Rui","family":"Ng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel S.","family":"Chong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"issue":"2","key":"512_CR1","doi-asserted-by":"publisher","first-page":"e144","DOI":"10.1016\/S2214-109X(20)30489-7","volume":"9","author":"JD Steinmetz","year":"2021","unstructured":"Steinmetz JD, Bourne RRA, Briant PS, Flaxman SR, Taylor HRB, Jonas JB, et al. 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