{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T21:56:24Z","timestamp":1784584584597,"version":"3.55.0"},"reference-count":99,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>The iStent series constitutes a range of trabecular bypass minimally invasive glaucoma surgery (MIGS) devices, which offers intraocular pressure (IOP) reduction with favourable safety profiles, in patients with open-angle glaucoma (OAG). Having undergone significant evolution since its initial US FDA-approval in 2012, successive generations address previous limitations, while enhancing IOP-lowering efficacy through device and delivery system design iterations. Longer-term and real-world iStent data demonstrate the durability of IOP- and medication-lowering outcomes with minimal complications, while preliminary studies across a wider spectrum of glaucoma subtypes and severities provide limited evidence of successful outcomes beyond mild-to-moderate OAG, both with and without concomitant cataract surgery. Aqueous humour outflow assessment and novel intra-operative techniques may further facilitate more accurate and effective iStent positioning. Despite typically higher upfront costs, results from both cost-effectiveness and patient-reported outcome studies are encouraging. Combination MIGS with the iStent, leveraging on the multiple mechanisms of actions of various procedures, may provide greater IOP-lowering efficacy without compromising safety. With expanding clinical data and progressive enhancements, iStent technology is likely to remain a key component of the evolving MIGS landscape.<\/jats:p>","DOI":"10.3389\/fmed.2025.1724886","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T05:16:48Z","timestamp":1769145408000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["From first generation to the next: evolution and research trends in iStent technology"],"prefix":"10.3389","volume":"12","author":[{"given":"Bryan Chin Hou","family":"Ang","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Tan Tock Seng Hospital, National Healthcare Group Eye Institute","place":["Singapore, Singapore"]},{"name":"Lee Kong Chian School of Medicine, Nanyang Technological University","place":["Singapore, Singapore"]},{"name":"Department of Ophthalmology, Mayo Clinic","place":["Jacksonville, FL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie Shi Qi","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Tan Tock Seng Hospital, National Healthcare Group Eye Institute","place":["Singapore, Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bjorn","family":"Betzler","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Tan Tock Seng Hospital, National Healthcare Group Eye Institute","place":["Singapore, Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng Yang","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Tan Tock Seng Hospital, National Healthcare Group Eye Institute","place":["Singapore, Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e144","DOI":"10.1016\/S2214-109X(20)30489-7","article-title":"Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the right to sight: an analysis for the global burden of disease study","volume":"9","author":"Steinmetz","year":"2021","journal-title":"Lancet Glob Health"},{"key":"ref2","volume-title":"Asia Pacific glaucoma guidelines","year":"2016"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"255","DOI":"10.4103\/tjo.tjo_63_20","article-title":"Intraocular pressure reduction in glaucoma: does every mmHg count?","volume":"10","author":"Jayaram","year":"2020","journal-title":"Taiwan J Ophthalmol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1097\/ICU.0b013e32834ff1e7","article-title":"Micro-invasive glaucoma surgery: current perspectives and future directions","volume":"23","author":"Saheb","year":"2012","journal-title":"Curr Opin Ophthalmol"},{"key":"ref5","first-page":"e0183142","article-title":"Minimally-invasive glaucoma surgeries (MIGS) for open angle glaucoma: A systematic review and meta-analysis","volume-title":"PLoS One.","author":"Lavia","year":"2017"},{"key":"ref6","year":""},{"key":"ref7","year":""},{"key":"ref8","year":""},{"key":"ref9","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1016\/j.ophtha.2013.11.001","article-title":"Gonioscopy-assisted transluminal trabeculotomy, ab interno trabeculotomy: technique report and preliminary results","volume":"121","author":"Grover","year":"2014","journal-title":"Ophthalmology"},{"key":"ref10","year":""},{"key":"ref11","doi-asserted-by":"publisher","first-page":"677","DOI":"10.2147\/OPTH.S57217","article-title":"A review of the iStent\u00ae trabecular micro-bypass stent: safety and efficacy","volume":"9","author":"Wellik","year":"2015","journal-title":"Clin Ophthalmol (Auckl NZ)"},{"key":"ref12","year":""},{"key":"ref13","year":""},{"key":"ref14","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1016\/j.exer.2005.10.011","article-title":"What controls aqueous humour outflow resistance?","volume":"82","author":"Johnson","year":"2006","journal-title":"Exp Eye Res"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1016\/j.ophtha.2010.07.007","article-title":"Randomized evaluation of the trabecular Micro-bypass stent with phacoemulsification in patients with Glaucoma and cataract","volume":"118","author":"Samuelson","year":"2011","journal-title":"Ophthalmology"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1007\/s40123-021-00424-4","article-title":"Standalone implantation of 2\u20133 trabecular Micro-bypass stents (iStent inject\u202f\u00b1\u202fiStent) as an alternative to trabeculectomy for moderate-to-severe Glaucoma","volume":"11","author":"Paletta Guedes","year":"2022","journal-title":"Ophthalmol Ther."},{"key":"ref17","year":""},{"key":"ref18","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.aopr.2024.09.002","article-title":"Real-world assessment of second-generation trabecular micro-bypass stents in open-angle glaucoma patients","volume":"5","author":"Vohra","year":"2025","journal-title":"Adv Ophthalmol Pract Res"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"3507","DOI":"10.2147\/OPTH.S271646","article-title":"Two-year multicenter outcomes of iStent inject trabecular Micro-bypass stents combined with phacoemulsification in various types of Glaucoma and ocular hypertension","volume":"14","author":"Clement","year":"2020","journal-title":"Clin Ophthalmol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1016\/j.ogla.2024.02.004","article-title":"Prospective, randomized controlled trial of cataract surgery vs combined cataract surgery with insertion of iStent inject","volume":"7","author":"Fan Gaskin","year":"2024","journal-title":"Ophthalmol Glaucoma"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"2488","DOI":"10.4103\/ijo.IJO_308_21","article-title":"iStent versus iStent inject implantation combined with phacoemulsification in open angle glaucoma","volume":"69","author":"Shalaby","year":"2021","journal-title":"Indian J Ophthalmol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1007\/s40123-019-0166-x","article-title":"Intermediate results of iStent or iStent inject implantation combined with cataract surgery in a real-world setting: A longitudinal retrospective study","volume":"8","author":"Guedes","year":"2019","journal-title":"Ophthalmol Ther"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1007\/s40123-019-00208-x","article-title":"Real-world case series of iStent or iStent inject trabecular Micro-bypass stents combined with cataract surgery","volume":"8","author":"Manning","year":"2019","journal-title":"Ophthalmol Ther."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"67","DOI":"10.5005\/jp-journals-10008-1248","article-title":"Efficacy and adverse event profile of the iStent and iStent inject trabecular micro-bypass for open-angle glaucoma: a meta-analysis","volume":"12","author":"Popovic","year":"2018","journal-title":"J Curr Glaucoma Pract"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"7259","DOI":"10.3390\/jcm12237259","article-title":"Comparison of the iStent inject\u00ae versus the iStent inject\u00ae W\u2014both in combination with cataract surgery\u2014in open-angle glaucoma","volume":"12","author":"Deneri","year":"2023","journal-title":"J Clin Med"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1097\/IJG.0000000000002141","article-title":"Effectiveness and safety of iStent infinite trabecular micro-bypass for uncontrolled glaucoma","volume":"32","author":"Sarkisian","year":"2023","journal-title":"J Glaucoma"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1007\/s40123-025-01126-x","article-title":"Six-month outcomes from a prospective, randomized study of iStent infinite versus Hydrus in open-angle glaucoma: the INTEGRITY study","volume":"14","author":"Ahmed","year":"2025","journal-title":"Ophthalmol Ther"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"811","DOI":"10.1016\/j.ophtha.2019.03.006","article-title":"Prospective, randomized, controlled pivotal trial of an ab interno implanted trabecular micro-bypass in primary open-angle glaucoma and cataract","volume":"126","author":"Samuelson","year":"2019","journal-title":"Ophthalmology"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"e14","DOI":"10.1016\/j.ophtha.2019.09.042","article-title":"Re: Samuelson et al.: prospective, randomized, controlled pivotal trial of an ab interno implanted trabecular micro-bypass in primary open-angle glaucoma and cataract: two-year results","volume":"127","author":"Melo Ara\u00fajo","year":"2020","journal-title":"Ophthalmology"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"2144","DOI":"10.1016\/S0161-6420(99)90497-9","article-title":"Early manifest Glaucoma trial: design and baseline data","volume":"106","author":"Leske","year":"1999","journal-title":"Ophthalmology"},{"key":"ref31","first-page":"26","article-title":"The effect of phacoemulsification on intraocular pressure in medically controlled open-angle Glaucoma patients","volume-title":"Am J Ophthalmol","author":"Slabaugh","year":"2014"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"1417","DOI":"10.1007\/s12325-021-02039-4","article-title":"iStent inject trabecular Micro-bypass with or without cataract surgery yields sustained 5-year Glaucoma control","volume":"39","author":"Hengerer","year":"2022","journal-title":"Adv Ther"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1219","DOI":"10.1007\/s40123-025-01134-x","article-title":"Five-year outcomes of iStent inject implantation with or without phacoemulsification in eyes with open-angle Glaucoma","volume":"14","author":"Guedes","year":"2025","journal-title":"Ophthalmol Ther."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"3281","DOI":"10.1007\/s40123-023-00824-8","article-title":"Five-year outcomes of single trabecular microbypass stent (iStent\u00ae) implantation with phacoemulsification in Korean patients","volume":"12","author":"Kim","year":"2023","journal-title":"Ophthalmol Ther."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"e0257015","DOI":"10.1371\/journal.pone.0257015","article-title":"5-year outcomes of single iStent (G1) trabecular microbypass implantation with phacoemulsification in moderately advanced primary open angle glaucoma","volume":"16","author":"Ansari","year":"2021","journal-title":"Plos One"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1186\/s40662-021-00263-1","article-title":"Long-term outcomes of two first-generation trabecular micro-bypass stents (iStent) with phacoemulsification in primary open-angle glaucoma: eight-year results","volume":"8","author":"Salimi","year":"2021","journal-title":"Eye Vis"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/j.ajo.2023.02.014","article-title":"Long-term endothelial safety profile with iStent inject in patients with open-angle Glaucoma","volume":"252","author":"Ahmed","year":"2023","journal-title":"Am J Ophthalmol"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"100015","DOI":"10.1016\/j.ajoint.2024.100015","article-title":"Ab interno minimally invasive glaucoma surgery combined with cataract surgery and cataract surgery alone: IRIS\u00ae registry study","volume":"1","author":"Mbagwu","year":"2024","journal-title":"AJO Int"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"1911","DOI":"10.1016\/j.jcrs.2012.07.017","article-title":"Using multiple trabecular micro-bypass stents in cataract patients to treat open-angle glaucoma","volume":"38","author":"Belovay","year":"2012","journal-title":"J Cataract Refract Surg"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"255","DOI":"10.2147\/OPTH.S152268","article-title":"Long-term titrated IOP control with one, two, or three trabecular micro-bypass stents in open-angle glaucoma subjects on topical hypotensive medication: 42-month outcomes","volume":"12","author":"Katz","year":"2018","journal-title":"Clin Ophthalmol"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"875","DOI":"10.2147\/OPTH.S59932","article-title":"Prospective unmasked randomized evaluation of the iStent inject (\u00ae) versus two ocular hypotensive agents in patients with primary open-angle glaucoma","volume":"8","author":"Fea","year":"2014","journal-title":"Clin Ophthalmol [Internet]"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1177\/112067210901900311","article-title":"Coexistent primary open-angle Glaucoma and cataract: interim analysis of a trabecular Micro-bypass stent and concurrent cataract surgery","volume":"19","author":"Spiegel","year":"2009","journal-title":"Eur J Ophthalmol"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1136\/bjophthalmol-2011-300218","article-title":"Combined iStent trabecular micro-bypass stent implantation and phacoemulsification for coexistent open-angle glaucoma and cataract: a long-term study","volume":"96","author":"Arriola-Villalobos","year":"2012","journal-title":"Br J Ophthalmol"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1007\/s12325-008-0062-6","article-title":"Coexistent primary open-angle glaucoma and cataract: preliminary analysis of treatment by cataract surgery and the iStent trabecular micro-bypass stent","volume":"25","author":"Spiegel","year":"2008","journal-title":"Adv Ther"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1007\/BF02850004","article-title":"Initial clinical experience with the trabecular micro-bypass stent in patients with glaucoma","volume":"24","author":"Spiegel","year":"2007","journal-title":"Adv Ther"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"321","DOI":"10.2147\/OPTH.S15025","article-title":"One-year analysis of the iStent trabecular microbypass in secondary glaucoma","volume":"5","author":"Duch","year":"2011","journal-title":"Clin Ophthalmol"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"1339","DOI":"10.1016\/j.jcrs.2012.03.025","article-title":"Cataract surgery with trabecular micro-bypass stent implantation in patients with mild-to-moderate open-angle glaucoma and cataract: two-year follow-up","volume":"38","author":"Craven","year":"2012","journal-title":"J Cataract Refract Surg"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1016\/j.jcrs.2009.10.031","article-title":"Phacoemulsification versus phacoemulsification with micro-bypass stent implantation in primary open-angle glaucoma: randomized double-masked clinical trial","volume":"36","author":"Fea","year":"2010","journal-title":"J Cataract Refract Surg"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"3327","DOI":"10.1167\/iovs.09-3972","article-title":"Fluorophotometric study of the effect of the Glaukos trabecular microbypass stent on aqueous humor dynamics","volume":"51","author":"Fern\u00e1ndez-Barrientos","year":"2010","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"30","DOI":"10.4103\/0974-9233.148346","article-title":"Trabecular micro-bypass shunt (iStent\u00aemicro-bypass stent for open-angle glaucoma: basic science, clinical, and future)","volume":"22","author":"Craven","year":"2015","journal-title":"Middle East Afr J Ophthalmol"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"1937","DOI":"10.2147\/OPTH.S45920","article-title":"iStent trabecular micro-bypass stent for open-angle glaucoma","volume":"8","author":"Le","year":"2014","journal-title":"Clin Ophthalmol"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1097\/IJG.0000000000001273","article-title":"A prospective analysis of iStent inject microstent positioning: Schlemm Canal dilatation and intraocular pressure correlations","volume":"28","author":"Gillmann","year":"2019","journal-title":"J Glaucoma"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"2309","DOI":"10.1177\/11206721231190417","article-title":"Novel surgical technique to manage iStent inject over-implantation","volume":"33","author":"Ang","year":"2023","journal-title":"Eur J Ophthalmol"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"e163","DOI":"10.1016\/j.jcjo.2016.06.017","article-title":"Recurrent hyphema following iStent surgery managed by surgical removal","volume":"51","author":"Khouri","year":"2016","journal-title":"Can J Ophthalmol"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"e28","DOI":"10.1097\/IJG.0000000000002539","article-title":"Schlemm\u2019s bidirectional fluid wave and luminal blood reflux as novel intraoperative signs confirming optimal placement of the iStent","volume":"34","author":"Ang","year":"2025","journal-title":"J Glaucoma"},{"key":"ref56","article-title":"Intraoperative predictors of success of iStent placement with cataract surgery","volume-title":"Can J Ophthalmol","author":"Sarohia","year":"2025"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"e151","DOI":"10.1097\/IJG.0000000000002232","article-title":"Intraoperative optical coherence tomography for ab Interno trabecular bypass Glaucoma surgery","volume":"32","author":"Ang","year":"2023","journal-title":"J Glaucoma"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"e617","DOI":"10.1111\/aos.14962","article-title":"Anterior segment imaging in minimally invasive glaucoma surgery \u2013 a systematic review","volume":"100","author":"Kan","year":"2022","journal-title":"Acta Ophthalmol"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"076008","DOI":"10.1117\/1.JBO.29.7.076008","article-title":"iStent insertion orientation and impact on trabecular meshwork motion resolved by optical coherence tomography imaging","volume":"29","author":"Gong","year":"2024","journal-title":"J Biomed Opt"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"1114","DOI":"10.1097\/IJG.0000000000000799","article-title":"Episcleral venous outflow: a potential outcome marker for iStent surgery","volume":"26","author":"Bostan","year":"2017","journal-title":"J Glaucoma"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1097\/IJG.0000000000001126","article-title":"Episcleral venous fluid wave in the living human eye adjacent to microinvasive glaucoma surgery (MIGS) supports laboratory research: outflow is limited circumferentially, conserved distally, and favored inferonasally","volume":"28","author":"Fellman","year":"2019","journal-title":"J Glaucoma"},{"key":"ref62","doi-asserted-by":"publisher","first-page":"600","DOI":"10.1097\/IJG.0000000000002195","article-title":"Intraocular pressure spikes following iStent inject and the relationship to aqueous outflow in open angle Glaucoma","volume":"32","author":"Lusthaus","year":"2023","journal-title":"J Glaucoma"},{"key":"ref63","doi-asserted-by":"publisher","first-page":"656","DOI":"10.1097\/IJG.0000000000001561","article-title":"The effects of trabecular bypass surgery on conventional aqueous outflow, visualized by hemoglobin video imaging","volume":"29","author":"Lusthaus","year":"2020","journal-title":"J Glaucoma"},{"key":"ref64","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1186\/s40662-020-00194-3","article-title":"iStent inject trabecular microbypass stent implantation with cataract extraction in open-angle glaucoma: early clinical experience","volume":"7","author":"Ferguson","year":"2020","journal-title":"Eye Vis"},{"key":"ref65","doi-asserted-by":"publisher","first-page":"4558","DOI":"10.1167\/iovs.16-19644","article-title":"Aqueous angiography-mediated guidance of trabecular bypass improves angiographic outflow in human enucleated eyes","volume":"57","author":"Huang","year":"2016","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"ref66","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1097\/IJG.0000000000001805","article-title":"Standalone iStent trabecular Micro-bypass Glaucoma surgery: A systematic review and Meta-analysis","volume":"30","author":"Healey","year":"2021","journal-title":"J Glaucoma"},{"key":"ref67","doi-asserted-by":"publisher","first-page":"740","DOI":"10.1111\/ceo.14408","article-title":"Angle-based minimally invasive glaucoma surgery in normal tension glaucoma: A systematic review and meta-analysis","volume":"52","author":"Oo","year":"2024","journal-title":"Clin Experiment Ophthalmol"},{"key":"ref68","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/s40662-022-00294-2","article-title":"Prospective 12-month outcomes of combined iStent inject implantation and phacoemulsification in Asian eyes with normal tension glaucoma","volume":"9","author":"Ang","year":"2022","journal-title":"Eye Vis."},{"key":"ref69","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1007\/s10792-021-02033-3","article-title":"12-month outcomes of combined phacoemulsification and iStent inject in Asian eyes with Normal tension Glaucoma: A single-Centre experience","volume":"42","author":"Ang","year":"2022","journal-title":"Int Ophthalmol"},{"key":"ref70","doi-asserted-by":"publisher","first-page":"976","DOI":"10.1007\/s12325-019-00899-5","article-title":"Case series of combined iStent implantation and phacoemulsification in eyes with primary angle closure disease: one-year outcomes","volume":"36","author":"Hernstadt","year":"2019","journal-title":"Adv Ther"},{"key":"ref71","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1016\/j.ajo.2020.12.032","article-title":"Matched cohort study of cataract surgery with and without trabecular microbypass stent implantation in primary angle-closure Glaucoma","volume":"224","author":"Salimi","year":"2021","journal-title":"Am J Ophthalmol"},{"key":"ref72","doi-asserted-by":"publisher","first-page":"2955","DOI":"10.2147\/OPTH.S373290","article-title":"Multicenter effectiveness and disease stability through 3 years after iStentTrabecular micro-bypass with phacoemulsification in glaucoma and ocular hypertension","volume":"16","author":"Clement","year":"2022","journal-title":"Clin Ophthalmol"},{"key":"ref73","doi-asserted-by":"publisher","first-page":"624179","DOI":"10.3389\/fmed.2020.624179","article-title":"Prevalence of primary angle closure Glaucoma in the last 20 years: A Meta-analysis and systematic review","volume":"7","author":"Zhang","year":"2020","journal-title":"Front Med"},{"key":"ref74","doi-asserted-by":"publisher","first-page":"1641","DOI":"10.1016\/j.ophtha.2004.03.029","article-title":"The prevalence of primary open-angle glaucoma in Japanese","volume":"111","author":"Iwase","year":"2004","journal-title":"Ophthalmology"},{"key":"ref75","doi-asserted-by":"publisher","first-page":"2081","DOI":"10.1016\/j.ophtha.2014.05.013","article-title":"Global prevalence of Glaucoma and projections of Glaucoma burden through 2040","volume":"121","author":"Tham","year":"2014","journal-title":"Ophthalmology"},{"key":"ref76","doi-asserted-by":"publisher","DOI":"10.1111\/ceo.14588","article-title":"Association between prior selective laser trabeculoplasty and phaco- iStent inject efficacy","author":"Tan","year":"2025","journal-title":"Clin Experiment Ophthalmol"},{"key":"ref77","doi-asserted-by":"publisher","first-page":"e0297514","DOI":"10.1371\/journal.pone.0297514","article-title":"Comparative evaluation of iStent versus iStent inject W combined with phacoemulsification in open angle glaucoma","volume":"19","author":"Morita","year":"2024","journal-title":"PLoS One"},{"key":"ref78","doi-asserted-by":"publisher","first-page":"e21729","DOI":"10.1097\/MD.0000000000021729","article-title":"Clinical outcomes of trabecular microbypass stent (iStent) implantation in medically controlled open-angle glaucoma in the Korean population","volume":"99","author":"Kim","year":"2020","journal-title":"Medicine"},{"key":"ref79","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.9084","article-title":"Plant-derived angiogenin fusion protein\u2019s cytoprotective effect on trabecular meshwork damage induced by benzalkonium chloride in mice","volume":"8","author":"Jeong","year":"2020","journal-title":"PeerJ"},{"key":"ref80","doi-asserted-by":"publisher","first-page":"109199","DOI":"10.1016\/j.exer.2022.109199","article-title":"Anti-glaucoma medications lowered decorin and altered profibrotic proteins in human tenon\u2019s fibroblasts","volume":"224","author":"Nikhalashree","year":"2022","journal-title":"Exp Eye Res"},{"key":"ref81","doi-asserted-by":"publisher","first-page":"954","DOI":"10.18240\/ijo.2022.06.13","article-title":"iStent inject\u00ae and cataract surgery for mild-to-moderate primary open angle glaucoma in Japan: a cost-utility analysis","volume":"15","author":"Igarashi","year":"2022","journal-title":"Int J Ophthalmol"},{"key":"ref82","doi-asserted-by":"publisher","first-page":"824","DOI":"10.1186\/s12913-021-06862-x","article-title":"Cost-utility analysis of trabecular micro-bypass stents (TBS) in patients with mild-to-moderate open-angle glaucoma in Italy","volume":"1","author":"Fea","year":"2021","journal-title":"BMC Health Serv Res"},{"key":"ref83","doi-asserted-by":"publisher","first-page":"e0049","DOI":"10.37039\/1982.8551.20220049","article-title":"A Brazilian cost-utility analysis of trabecular micro-bypass with iStent inject\u00ae for the treatment of open-angle glaucoma","volume":"81","author":"Guedes","year":"2022","journal-title":"Rev Bras Oftalmol"},{"key":"ref84","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1007\/s41669-021-00312-4","article-title":"A cost-utility analysis of trabecular bypass devices versus usual care for patients with open-angle Glaucoma","volume":"6","author":"Healey","year":"2022","journal-title":"PharmacoEconomics Open"},{"key":"ref85","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1080\/13696998.2019.1572013","article-title":"Cost-effectiveness analysis of standalone trabecular micro-bypass stents in patients with mild-to-moderate open-angle glaucoma in Canada","volume":"22","author":"Patel","year":"2019","journal-title":"J Med Econ"},{"key":"ref86","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1080\/03007995.2018.1506022","article-title":"Cost-effectiveness analysis of iStent trabecular micro-bypass stent for patients with open-angle glaucoma in Colombia","volume":"35","author":"Ord\u00f3\u00f1ez","year":"2019","journal-title":"Curr Med Res Opin"},{"key":"ref87","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1016\/j.ajo.2021.03.007","article-title":"Quality of life in primary open-angle glaucoma and cataract: an analysis of VFQ-25 and OSDI from the iStent inject\u00ae pivotal trial","volume":"229","author":"Samuelson","year":"2021","journal-title":"Am J Ophthalmol"},{"key":"ref88","doi-asserted-by":"publisher","first-page":"941","DOI":"10.1007\/s40123-020-00290-6","article-title":"Prospective interventional cohort study of ocular surface disease changes in eyes after trabecular Micro-bypass stent(s) implantation (iStent or iStent inject) with phacoemulsification","volume":"9","author":"Schweitzer","year":"2020","journal-title":"Ophthalmol Ther."},{"key":"ref89","first-page":"25158414231152765","article-title":"Impact of minimally invasive glaucoma surgery on the ocular surface and quality of life in patients with glaucoma","volume-title":"Ther Adv Ophthalmol","author":"Jones","year":"2023"},{"key":"ref90","doi-asserted-by":"publisher","first-page":"3049","DOI":"10.2147\/OPTH.S276124","article-title":"Quality of life after combined cataract and minimally invasive glaucoma surgery in glaucoma patients","volume":"14","author":"Al Habash","year":"2020","journal-title":"Clin Ophthalmol Auckl NZ."},{"key":"ref91","doi-asserted-by":"publisher","first-page":"CD012740","DOI":"10.1002\/14651858.CD012740.pub2","article-title":"Ab interno trabecular bypass surgery with Schlemm\u2019s canal microstent (Hydrus) for open angle glaucoma","volume":"3","author":"Otarola","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"ref92","doi-asserted-by":"publisher","first-page":"983","DOI":"10.1001\/jamaophthalmol.2021.2351","article-title":"Minimally invasive glaucoma surgical techniques for open-angle glaucoma: an overview of Cochrane systematic reviews and network meta-analysis","volume":"139","author":"Bicket","year":"2021","journal-title":"JAMA Ophthalmol"},{"key":"ref93","doi-asserted-by":"publisher","first-page":"e051496","DOI":"10.1136\/bmjopen-2021-051496","article-title":"Comparison of Hydrus and iStent microinvasive glaucoma surgery implants in combination with phacoemulsification for treatment of open-angle glaucoma: systematic review and network meta-analysis","volume":"12","author":"Hu","year":"2022","journal-title":"BMJ Open"},{"key":"ref94","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1097\/IJG.0000000000002522","article-title":"Kahook dual blade goniotomy versus iStent implantation combined with phacoemulsification: a systematic review and meta-analysis","volume":"34","author":"Guedes","year":"2025","journal-title":"J Glaucoma"},{"key":"ref95","doi-asserted-by":"publisher","first-page":"2083","DOI":"10.1177\/11206721251338996","article-title":"Three-years follow-up of combined phacoemulsification, iStent and endocyclophotocoagulation","volume":"35","author":"Fernandez-Alcalde","year":"2025","journal-title":"Eur J Ophthalmol"},{"key":"ref96","doi-asserted-by":"publisher","first-page":"1378","DOI":"10.1136\/bjophthalmol-2019-315434","article-title":"Outcomes of phacoemulsification combined with two iStent inject trabecular microbypass stents with or without endocyclophotocoagulation","volume":"104","author":"Pantalon","year":"2020","journal-title":"Br J Ophthalmol"},{"key":"ref97","doi-asserted-by":"publisher","first-page":"25158414221125697","DOI":"10.1177\/25158414221125697","article-title":"A comparison of iStent combined with phacoemulsification and endocyclophotocoagulation (ICE2) with the PreserFlo MicroShunt and XEN-45 implants","volume":"14","author":"Qidwai","year":"2022","journal-title":"Ther Adv Ophthalmol"},{"key":"ref98","doi-asserted-by":"publisher","first-page":"2879","DOI":"10.2147\/OPTH.S431356","article-title":"Comparing outcomes of phacoemulsification and Endocyclophotocoagulation with either dual blade Goniotomy (PEcK) or two trabecular stents (ICE2)","volume":"17","author":"El Helwe","year":"2023","journal-title":"Clin Ophthalmol"},{"key":"ref99","doi-asserted-by":"publisher","first-page":"1533","DOI":"10.2147\/OPTH.S215667","article-title":"Ab interno canaloplasty combined with trabecular bypass stenting in eyes with primary open-angle glaucoma","volume":"13","author":"Heersink","year":"2019","journal-title":"Clin Ophthalmol"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1724886\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T08:30:49Z","timestamp":1771921849000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1724886\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,23]]},"references-count":99,"alternative-id":["10.3389\/fmed.2025.1724886"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1724886","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,23]]},"article-number":"1724886"}}