Implantation of iStent inject (Glaukos) during phacoemulsification in patients with mild-to-moderate primary open-angle glaucoma (POAG) did not produce any device-related complications or endothelial cell density (ECD) safety concerns compared to phacoemulsification alone through 60 months, according to a study published in the American Journal of Ophthalmology. Out of the 227 patients who elected to participate (iStent inject and phacoemulsification group, n=178; phacoemulsification-alone control group, n=49), no significant differences were observed in mean ECD, mean percentage change in ECD, or proportion of eyes with >30% endothelial cell loss (ECL) between the iStent inject and control groups at any time point. For both groups, the rate of ECL was greatest during the first 3 months after surgery, then was relatively stable throughout the 60-month follow-up period. Mean percentage decrease in ECD at 60 months was 14.3±13.4% in the iStent inject group and 14.8±10.3% in the control group (P=.8112). The annualized rate of ECD change from 3 to 60 months was neither clinically nor statistically significant between groups. These findings suggest that iStent inject implantation during cataract surgery does not result in more endothelial damage when compared with cataract surgery alone.