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Table 2. Summary of efficacy results from studies included in the review
Combination/ Study Medication
Technique Study Population IOP change (%)
standalone design reduction
Schlemm’s canal
iStent Hooshmand et al. [5] + CE PCS 245 eyes 18 mo: -13.23 18 mo: -0.8
Ferguson et al. [6] + CE RCS 24 eyes 36 mo: -24.72 36 mo: -0.16
Ferguson et al. [7] + CE RCS 115 eyes 24 mo: -27.45 24 mo: -0.7
Ahmed et al. [8] + CE RCT 75 eyes 12 mo: -5.24 12 mo: -1.0
Katz et al. [9] Standalone RCT 119 subjects 42 mo: -21.89 42 mo: - 1.65
iStent inject Hooshmand et al. [5] + CE PCS 245 eyes 18 mo: -11.64 18 mo: -0.8
Samuelson et al. [10] + CE RCT 505 eyes 24 mo: -40 24 mo: -1.2
Hydrus Samuelson et al. [4] + CE RCT 556 eyes 24 mo: -43.68 24 mo: -1.4
Ahmed et al. [8] + CE RCT 73 eyes 12 mo: -8.95 12 mo: -1.6
ABiC Davids et al. [11] +/- CE RCS 36 eyes 12 mo: -30.3 12 mo: -0.37
Heersink et al. [12] + CE + iStent RCS 86 eyes 6 mo: -17.47 6 mo: -0.9
Trabectome Esfandiari et al. [13] + CE RCS 154 eyes 24 mo: -9.15 24 mo: -0.6
Avar et al. [14] +/- CE RCS 154 eyes 60 mo: -25.22 60 mo: -1.3
GATT Olgun et al. [15] +/- CE RCS 107 eyes 24 mo: -38.55 24 mo: -2.1
Goniotomy Elmallah et al. [16] + CE RCS 315 eyes 12 mo: -27.47 12 mo: -1.03
Supraciliary space/ciliary process
CyPass Vold et al. [17] + CE RCT 374 subjects 24 mo: -30.33 24 mo: -1.2
Reiss et al. [18] + CE RCT 215 subjects 60 mo: -34.29 n/a
Fard et al. [19] + CE SR/MA 274 subjects 24 mo: -35.7 24 mo: -0.66
Fard et al. [19] Standalone SR/MA 182 subjects 24 mo: -16.1 24 mo: -1.24
iStent Supra Myers et al. [20] + 2 iStent PCS 80 subjects 48 mo: -41.36 n/a
ECP Pantalon et al. [21] + CE + 2 iStent PCS 63 eyes 12 mo: -34.65 12 mo: -0.98
Subconjunctival space
XEN Gel Stent Olgun et al. [15] +/- CE RCS 114 eyes 24 mo: -41.8 24 mo: -2
Karimi et al. [22] +/- CE RCS 226 subjects 18 mo: -30.05 18 mo: -1.5
Wagner et al. [23] Standalone RCS 171 eyes 12 mo: -37.89 12 mo: -1.7
Gillmann et al. [24] +/- CE PCS 110 eyes 24 mo: -27.53 24 mo: -1.45
MicroShunt Sadruddin et al. [25] +/- CE RA 23 patients 36 mo: -44.96 36 mo: -1.7

CE: Cataract extraction; PCS: prospective case series; RCS: retrospective case series; RCT: randomised controlled trial; SR/MA:
systematic review and meta-analysis; RA: review article.

OR trabecular)]. After this, 2 reviewers (K.K. and P.R.) independently screened the retrieved records
to identify eligible studies with discrepancies resolved by discussion. The reference lists of the searched
studies were also analysed to identify any suitable papers that were not identified by the search. The initial
screening was performed based on title and abstract for relevance, with subsequent in-depth screenings
based on full-text analysis. The 2 reviewers (K.K and P.R) then selected the most significant articles for each
MIGS technique from the eligible studies for inclusion, based on a ranking criteria, prioritising studies on
the strength of their design, recency, and the size of the study.

RESULTS
Description of included trials
484 papers were identified from the literature search. The abstracts of these papers were screened by 2
authors. 8 papers were excluded as duplicates, and 313 were excluded for not meeting the inclusion criteria,
163 papers were selected as relevant based on the specified search criteria. Using these relevant articles, 2
authors independently prepared a list of the most significant publications for each MIGS technique based
on study size, recency and strength of the study design. After cross-referencing both lists, the 2 authors
reached a consensus as to the articles which would be included in the review, and this decision was
reviewed by senior authors. After resolving discrepancies in the lists, 25 studies were finally included in the
review (details listed comprehensively in Supplementary Table 1).

Key statistics on mechanism of action, effectiveness, and safety profile were extracted for each type of
MIGS (an overview of these findings summarised in Table 2). Analysed procedures were limited to