The surgical management of glaucoma: A review

Abstract

After a long period of little change, glaucoma surgery has experienced a dramatic rise in the number of possible procedures in the last two decades. Glaucoma filtering surgeries with mitomycin C and glaucoma drainage devices remain the standard of surgical care. Other newer surgeries, some of which are minimally or microinvasive glaucoma surgeries, target existing trabecular outflow, enhance suprachoroidal outflow, create subconjunctival blebs, or reduce aqueous production. Some require the implantation of a device such as the iStent, Hydrus, Ex-PRESS, XEN and PRESERFLO, whilst others do not-Trabectome, Kahook dual blade, Ab interno canaloplasty, gonioscopy-assisted transluminal trabeculotomy, OMNI and excimer laser trabeculotomy. Others are a less destructive variation of an established procedure, such as micropulse transscleral cyclophotocoagulation, endoscopic cyclophotocoagulation and ultrasound cycloplasty. Cataract surgery alone can be a significant glaucoma operation. These older and newer glaucoma surgeries, their mechanism of action, efficacy and complications are the subject of this review.

The effect of Stab incision glaucoma filtering surgery on Intraocular pressure in primary angle closure glaucoma

“…The aqueous is directed only posteriorly because a single step creates the tunnel compared to three-direction leakage, which happens in classic trabeculectomy and decreases the bleb complications such as overhanging. A signi cant advantage of this technique is that it can be closed rapidly in case of expulsive haemorrhage [10] .…”

Risk factors associated with XEN gel stent‐related endophthalmitis

“…Jennifer C. Fan Gaskin MD, FRANZCO 1,2,3 Bob Z. Wang FRANZCO 1 Nicholas Toalster BApSciOptom(Hons), FRANZCO 1 Ghee Soon Ang FRANZCO…”

“…We read with great interest the recent review article by Ridia Lim on the surgical management of glaucoma. 1 Lim described the unchanging landscape of glaucoma surgery for over 50 years, consisting primarily of only trabeculectomy and glaucoma drainage implants, to the recent explosion of alternative procedures that have entered the glaucoma surgical sphere, including various minimally invasive glaucoma surgery (MIGS) devices. Lim provided a succinct review of the individual operations, categorised by the site of surgical approach (ab interno vs. ab externo), and the target outflow structure (subconjunctival, trabecular or suprachoroidal).…”

Fingertip-Measured Skin Carotenoids and Advanced Glycation End Product Levels in Glaucoma

“…Elevated intraocular pressure (IOP) is a major risk factor, and lowering the IOP through medication or surgery is the main therapeutic option. Numerous risk factors, such as genetics, inflammation, ocular blood flow, and oxidative stress have been proposed by diverse nonclinical and clinical studies; however, the only reliable parameter used in clinical practice is IOP [ 5 , 6 ]. Elevated IOP levels are associated with retinal ganglion cell (RGC) death and inhibit blood flow, leading to oxidative stress [ 7 , 8 , 9 ].…”