{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T13:17:01Z","timestamp":1779110221231,"version":"3.51.4"},"reference-count":21,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The T-hook is a recently introduced device for ab interno trabeculotomy, first reported in 2022. This study compared the one-year surgical outcomes of Kahook Dual Blade (K group)- and T-hook (T group)-assisted trabeculotomy combined with phacoemulsification in patients with primary open-angle glaucoma (POAG). Methods: This retrospective study included patients with POAG who underwent 180\u00b0 ab interno trabeculotomy combined with phacoemulsification at our institution between June 2018 and September 2024 and were followed for at least 12 months. Changes in intraocular pressure (IOP), mean IOP reduction rate, number of antiglaucoma medications, postoperative complications (hyphema and transient IOP spikes), and cumulative surgical success rates were evaluated. Results: A total of 45 patients (61 eyes) were included, comprising 29 patients (42 eyes) in the K group and 16 patients (19 eyes) in the T group. A transient increase in IOP at one week postoperatively observed in the K group (p &lt; 0.0001); however, both groups demonstrated significant IOP reduction from baseline after 1 month (p &lt; 0.05). The mean IOP reduction rate at 12 months did not differ significantly between groups (p = 0.0720, ANCOVA). The number of antiglaucoma medications significantly decreased at all postoperative time points in both groups compared with baseline (p &lt; 0.05). Kaplan\u2013Meier survival analysis revealed no significant difference in cumulative surgical success rates between groups (p = 0.6217). The incidence of hyphema was comparable between groups (p = 1.00), whereas transient IOP spikes occurred significantly more frequently in the K group (p = 0.0057). Conclusions: While both procedures demonstrated comparable intraocular pressure-lowering efficacy, T-hook-assisted trabeculotomy was associated with fewer transient postoperative IOP spikes during the early postoperative period in this cohort.<\/jats:p>","DOI":"10.3390\/jcm15103834","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T12:36:40Z","timestamp":1779107800000},"page":"3834","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative One-Year Outcomes of T-Hook\u00ae-Versus Kahook Dual Blade\u00ae-Assisted Ab Interno Trabeculotomy Combined with Phacoemulsification for Primary Open-Angle Glaucoma"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4121-3584","authenticated-orcid":false,"given":"Yoshitaka","family":"Hoshino","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Kansai Medical University, Osaka 573-1010, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0671-6179","authenticated-orcid":false,"given":"Masatoshi","family":"Omi","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Kansai Medical University, Osaka 573-1010, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidetsugu","family":"Mori","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Kansai Medical University, Osaka 573-1010, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masato","family":"Ishino","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Kansai Medical University, Osaka 573-1010, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsunori","family":"Kiriishi","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Kansai Medical University, Osaka 573-1010, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shimpei","family":"Oba","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Kansai Medical University, Osaka 573-1010, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8879-3604","authenticated-orcid":false,"given":"Hisanori","family":"Imai","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Kansai Medical University, Osaka 573-1010, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,15]]},"reference":[{"key":"ref_1","first-page":"e52183","article-title":"The evolution and current landscape of minimally invasive glaucoma surgeries: A review","volume":"16","author":"Cheema","year":"2024","journal-title":"Cureus"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1016\/j.ogla.2021.03.012","article-title":"Trends and usage patterns of minimally invasive glaucoma surgery in the United States: IRIS Registry analysis 2013\u20132018","volume":"4","author":"Yang","year":"2021","journal-title":"Ophthalmol. Glaucoma"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"110","DOI":"10.4103\/joco.joco_45_23","article-title":"Ab-interno trabeculotomy procedures: A review","volume":"35","author":"Meshksar","year":"2023","journal-title":"J. Curr. Ophthalmol."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Balas, M., and Mathew, D.J. (2023). Minimally invasive glaucoma surgery: A review of the literature. Vision, 7.","DOI":"10.3390\/vision7030054"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2369","DOI":"10.2147\/OPTH.S224643","article-title":"Early results of goniotomy with the Kahook Dual Blade, a novel device for the treatment of glaucoma","volume":"13","author":"Kornmann","year":"2019","journal-title":"Clin. Ophthalmol."},{"key":"ref_6","doi-asserted-by":"crossref","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":"ref_7","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.2147\/OPTH.S358871","article-title":"Interim analysis of STREAMLINE surgical system clinical outcomes in eyes with glaucoma","volume":"16","author":"Garg","year":"2022","journal-title":"Clin. Ophthalmol."},{"key":"ref_8","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":"ref_9","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1097\/ICU.0000000000000458","article-title":"Suprachoroidal shunts","volume":"29","author":"Vinod","year":"2018","journal-title":"Curr. Opin. Ophthalmol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1540","DOI":"10.1038\/s41433-025-03707-3","article-title":"Five-year follow-up with the PreserFlo MicroShunt for open-angle glaucoma","volume":"39","author":"Scheres","year":"2025","journal-title":"Eye"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"3919","DOI":"10.2147\/OPTH.S392021","article-title":"Development and application of a new T-shaped internal trabeculotomy hook (T-hook)","volume":"16","author":"Chihara","year":"2022","journal-title":"Clin. Ophthalmol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Mori, H., Kiriishi, T., Omi, M., Ohnaka, M., and Imai, H. (2024). One-year outcomes of trabeculotomy with 120\u00b0, 180\u00b0, or 360\u00b0 Schlemm\u2019s canal incision for primary open-angle glaucoma: A retrospective study. J. Clin. Med., 13.","DOI":"10.3390\/jcm13247653"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Tanito, M., Sugihara, K., Tsutsui, A., Hara, K., Manabe, K., and Matsuoka, Y. (2021). Midterm results of microhook ab interno trabeculotomy in initial 560 eyes with glaucoma. J. Clin. Med., 10.","DOI":"10.3390\/jcm10040814"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Chihara, E., and Chihara, T. (2025). Mid-term surgical outcomes of T-hook, 360\u00b0 suture trabeculotomy, Kahook Dual Blade, and Tanito Microhook procedures: A comparative study. J. Clin. Med., 14.","DOI":"10.20944\/preprints202506.0307.v1"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"663","DOI":"10.2147\/OPTH.S498940","article-title":"Comparing the effectiveness of propensity score-matched ab interno trabeculotomy between two types of trabecular hooks","volume":"19","author":"Nakagawa","year":"2025","journal-title":"Clin. Ophthalmol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Okada, N., Hirooka, K., Onoe, H., Okumichi, H., and Kiuchi, Y. (2023). Comparison of mid-term outcomes between microhook ab interno trabeculotomy and goniotomy with the Kahook Dual Blade. J. Clin. Med., 12.","DOI":"10.3390\/jcm12020558"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e121","DOI":"10.1097\/IJG.0000000000002243","article-title":"Outcomes of iStent Inject versus Kahook Dual Blade surgery in glaucoma patients undergoing cataract surgery","volume":"32","author":"Barkander","year":"2023","journal-title":"J. Glaucoma"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"791","DOI":"10.2147\/OPTH.S158403","article-title":"A multicenter retrospective comparison of goniotomy versus trabecular bypass device implantation in glaucoma patients undergoing cataract extraction","volume":"12","author":"Dorairaj","year":"2018","journal-title":"Clin. Ophthalmol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/S0021-5155(01)00322-7","article-title":"Transient intraocular pressure elevation after trabeculotomy and its occurrence with phacoemulsification and intraocular lens implantation","volume":"45","author":"Inatani","year":"2001","journal-title":"Jpn. J. Ophthalmol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Kaneda, S., Fujishiro, T., Omoto, T., Fujino, R., Ishii, K., and Aihara, M. (2022). The effects of antithrombotic therapy in ab interno trabeculotomy with a spatula-shaped microhook. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0262548"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Wu, T., Ji, Q., Liao, Y., Zhao, X., and Hong, Y. (2025). Aqueous humor cytokine levels and illuminated microcatheter-assisted circumferential trabeculotomy outcome in open-angle glaucoma patients: A 24-month prospective study. Front. Immunol., 16.","DOI":"10.3389\/fimmu.2025.1575909"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/10\/3834\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T13:00:15Z","timestamp":1779109215000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/10\/3834"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,15]]},"references-count":21,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["jcm15103834"],"URL":"https:\/\/doi.org\/10.3390\/jcm15103834","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,15]]}}}