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Initial Treatment for Primary Angle-Closure Glaucoma in China.

Yuan Bo Liang1, Ning Li Wang, Shi Song Rong

  • 1*The Affiliated Eye Hospital, School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang Province †Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong ‡Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Lab, Beijing, China §Queensland Eye Institute, University of Queensland, Qld, Australia.

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Summary

In China, initial trabeculectomy is a common treatment for primary angle-closure glaucoma (PACG), offering better intraocular pressure (IOP) control and fewer complications than other methods. Further research is needed for developing countries.

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Area of Science:

  • Ophthalmology
  • Glaucoma Research
  • Surgical Interventions

Background:

  • Primary angle-closure glaucoma (PACG) presents a significant health burden in China.
  • Current treatment strategies in China differ from global norms, with trabeculectomy as a primary approach for PACG.

Purpose of the Study:

  • To evaluate the efficacy and rationale behind using trabeculectomy as an initial treatment for PACG in the Chinese population.
  • To compare trabeculectomy with laser peripheral iridotomy for PACG management in this region.

Main Methods:

  • Retrospective analysis of PACG treatment approaches in China.
  • Comparison of outcomes between initial trabeculectomy and laser peripheral iridotomy.
  • Assessment of intraocular pressure (IOP) reduction, acute angle closure frequency, and disease progression.

Main Results:

  • Trabeculectomy demonstrates superior IOP reduction and stability compared to laser peripheral iridotomy for PACG.
  • Initial trabeculectomy is associated with a lower incidence of acute angle closure and reduced glaucoma progression.
  • Fewer ocular complications were observed with initial trabeculectomy, especially concerning long-term medication use.

Conclusions:

  • Initial trabeculectomy is a supported and effective primary treatment for PACG in China, particularly in cases without significant lens opacities.
  • The approach offers advantages in IOP control, disease stabilization, and complication reduction.
  • Further investigation is warranted to establish optimal indications and assess effectiveness in developing country contexts.