Is Schlemm canal surgery suitable for primary angle-closure glaucoma?
10.3760/cma.j.cn115989-20211102-00598
- VernacularTitle:Schlemm管手术是否适用于原发性闭角型青光眼的治疗
- Author:
Li TANG
1
;
Huiping YUAN
;
Guangxian TANG
;
Sujie FAN
;
Lan LU
;
Minwen ZHOU
;
Lin XIE
;
Xin NIE
;
Xiulan ZHANG
Author Information
1. 四川大学华西医院眼科，成都 610041
- Keywords:
Primary angle-closure glaucoma;
Minimally invasive surgical procedures;
Schlemm canal;
Intraocular pressure
- From:
Chinese Journal of Experimental Ophthalmology
2022;40(4):340-344
- CountryChina
- Language:Chinese
-
Abstract:
Primary angle-closure glaucoma (PACG) is a common subtype of glaucoma and one of the leading causes of blindness in Asia.Trabeculectomy has been recognized as an effective filtering surgery for PACG and is widely used in clinical practice, but its high risk of postoperative complications, especially bleb scarring over time can not be ignored.Nowadays, non-bleb-based minimally invasive glaucoma surgeries (MIGS) have attracted much attention.Surgeries opening, restoring, or expanding Schlemm canal to reconstruct aqueous humor outflow pathway is one of the MIGS and able to achieve moderate intraocular pressure (IOP) reduction, which has been widely used in the treatment of primary open-angle glaucoma (POAG) for a long time.However, based on the pathogenesis of PACG and its similar pathological changes in Schlemm canal to POAG, some retrospective studies and prospective single-arm studies discovered that Schlemm canal surgery combined with phacoemulsification and/or goniosynechialysis appears to lower IOP well and safe in PACG eyes in recent years.Whether Schlemm canal surgery is also suitable or effective for PACG is getting some attention and is still controversial up to now, mostly due to some differences in pathogenesis between PACG and POAG, it is necessary to perform randomized controlled trials to confirm the efficacy of Schlemm canal surgery for PACG and upgrade the therapeutic strategy of PACG.
