In this article published in the British Journal of Ophthalmology (online first, September 2025), Dr Jeremy Tan and colleagues compare the long-term outcomes of combined phacoemulsification with Hydrus versus iStent inject microstent implantation in glaucoma surgery, using real-world registry data over 48 months. They found no significant difference in surgical success (≈ 41 % vs 43 %) or in intraocular pressure reduction, medication reduction, adverse events, and secondary procedures between the two groups. Thus, both devices show similar effectiveness and safety profiles at 4 years in routine clinical settings.