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Related Concept Videos

Open Angle Glaucoma: Treatment01:27

Open Angle Glaucoma: Treatment

In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
Drugs such as carbonic anhydrase inhibitors, α2- and...
Angle Closure Glaucoma: Treatment01:28

Angle Closure Glaucoma: Treatment

Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
Glaucoma: Overview01:25

Glaucoma: Overview

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Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

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Related Experiment Video

Updated: May 18, 2026

Glaucoma-inducing Procedure in an In Vivo Rat Model and Whole-mount Retina Preparation
08:30

Glaucoma-inducing Procedure in an In Vivo Rat Model and Whole-mount Retina Preparation

Published on: March 12, 2016

Medical versus surgical interventions for open angle glaucoma.

Jennifer Burr1, Augusto Azuara-Blanco, Alison Avenell

  • 1School of Medicine, Medical and Biological Sciences Building, University of St Andrews, Fife, UK. jmb28@st-andrews.ac.uk.

The Cochrane Database of Systematic Reviews
|September 14, 2012
PubMed
Summary

Initial surgery for open-angle glaucoma (OAG) lowers intraocular pressure more than medication but causes more discomfort. Visual field loss was similar at five years, but surgery may be better for severe OAG.

Related Experiment Videos

Last Updated: May 18, 2026

Glaucoma-inducing Procedure in an In Vivo Rat Model and Whole-mount Retina Preparation
08:30

Glaucoma-inducing Procedure in an In Vivo Rat Model and Whole-mount Retina Preparation

Published on: March 12, 2016

Area of Science:

  • Ophthalmology
  • Clinical Trials
  • Glaucoma Research

Background:

  • Open-angle glaucoma (OAG) is a leading cause of irreversible blindness worldwide.
  • Effective management of OAG is crucial to prevent vision loss.

Purpose of the Study:

  • To compare the efficacy and safety of initial medication versus initial surgery for treating adults with OAG.
  • To evaluate long-term outcomes, including visual field progression and intraocular pressure (IOP) control.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs).
  • Searched multiple databases including CENTRAL, MEDLINE, EMBASE, LILACS, BIOSIS, CINAHL, OpenGrey, Zetoc, mRCT, and WHO ICTRP up to August 2012.
  • Included four RCTs with 888 participants comparing primary medication (pilocarpine or beta-blocker) with surgery (Scheie's procedure or trabeculectomy).

Main Results:

  • Initial trabeculectomy lowered IOP more than medication (mean difference 2.20 mmHg) but was associated with more eye symptoms.
  • No significant difference in progressive visual field loss at five years between initial medication and trabeculectomy (OR 0.74, 95% CI 0.54 to 1.01).
  • Exploratory analysis suggested trabeculectomy may offer marginally less visual field loss in severe OAG.
  • Longer-term, medication showed a higher risk of treatment failure (OR 3.90) and trabeculectomy increased cataract risk (OR 2.69).

Conclusions:

  • Primary surgery effectively lowers IOP but increases ocular discomfort compared to medication.
  • Current evidence suggests similar visual field outcomes at five years, but surgery may be more effective for severe OAG.
  • Further RCTs are needed to evaluate contemporary medications against surgery, especially for severe glaucoma and in diverse ethnic groups, incorporating patient-reported outcomes and economic evaluations.