Mid-Term Surgical Outcomes of T-Hook, 360° Suture Trabeculotomy, Kahook Dual Blade, and Tanito Microhook Procedures: A Comparative Study

<b>Aim</b>: To compare the three-year surgical outcomes among the Kahook dual blade (KDB), Tanito microhook (TMH), T-hook, and 360° suture trabeculotomy (S-lot) cohorts. <b>Study design</b>: Retrospective interventional comparative study conducted at a single eye center. <b>Subjects and Methods</b>: A total of 224 eyes that underwent combined cataract surgery with either KDB, TMH, T-hook, or S-lot procedures were retrospectively analyzed over the three-year period. <b>Results</b>: According to Tukey's multiple comparison test, postoperative intraocular pressure (IOP) in the S-lot cohort was significantly lower than in the TMH cohort from 1 month to 3 years (<i>p</i> = 0.01 to <0.001), lower than in the KDB cohort between 6 months and 1 year (<i>p</i> = 0.026 to <0.001), and lower than in the T-hook cohort at 1 month (<i>p</i> = 0.012) and from 6 to 12 months (<i>p</i> < 0.001). The survival probability of achieving ≤15 mmHg and ≤18 mmHg in the S-lot cohort was significantly better than in others by <i>p</i> < 0.001 and 0.005, respectively. At 3 months, the T-hook cohort showed significantly lower IOP than the TMH cohort (<i>p</i> = 0.029), and at 1 week, IOP was marginally lower than in the KDB (<i>p</i> = 0.063) and TMH (<i>p</i> = 0.052) cohorts, based on Dunnett's test. However, no significant differences in postoperative IOP were observed among the three sectorial canal-opening surgery (COS) groups beyond 6 months. <b>Conclusions</b>: Among the four MIGS cohorts, S-lot provided the most substantial mid-term postoperative IOP reduction. The T-hook cohort showed marginally superior IOP reduction at 1 week compared to the KDB and TMH groups.