A two-year study evaluated the effectiveness and safety of an ab interno gelatin implant in reducing intraocular pressure (IOP) and medication use in patients with medically uncontrolled moderate primary open-angle glaucoma (POAG). The study involved 202 eyes (of 218 implanted) across eight countries. Eyes were implanted with either a gelatin implant alone or in combination with phacoemulsification. The mean IOP decreased from 21.4 mmHg at baseline to 14.9 mmHg at 12 months and 15.2 mmHg at 24 months. The number of IOP-lowering medications also decreased significantly. The clinical success rate was 67.6% at 12 months and 65.8% at 24 months, with 51.1% and 44.7% of eyes becoming medication-free. The implant showed a favorable safety profile compared to trabeculectomy and tube shunts. The gelatin implant effectively reduced IOP and medication needs over 2 years in patients with medically uncontrolled POAG, with an acceptable safety profile. The study demonstrated that the implant is a viable minimally invasive option for glaucoma treatment.A two-year study evaluated the effectiveness and safety of an ab interno gelatin implant in reducing intraocular pressure (IOP) and medication use in patients with medically uncontrolled moderate primary open-angle glaucoma (POAG). The study involved 202 eyes (of 218 implanted) across eight countries. Eyes were implanted with either a gelatin implant alone or in combination with phacoemulsification. The mean IOP decreased from 21.4 mmHg at baseline to 14.9 mmHg at 12 months and 15.2 mmHg at 24 months. The number of IOP-lowering medications also decreased significantly. The clinical success rate was 67.6% at 12 months and 65.8% at 24 months, with 51.1% and 44.7% of eyes becoming medication-free. The implant showed a favorable safety profile compared to trabeculectomy and tube shunts. The gelatin implant effectively reduced IOP and medication needs over 2 years in patients with medically uncontrolled POAG, with an acceptable safety profile. The study demonstrated that the implant is a viable minimally invasive option for glaucoma treatment.