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Related Concept Videos

Open Angle Glaucoma: Treatment01:27

Open Angle Glaucoma: Treatment

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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.
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Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
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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...
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Ophthalmic drug delivery faces major limitations due to poor absorption across the corneal membrane. This process is primarily driven by diffusion and is influenced by two main factors: the physicochemical properties of the drug and tear drainage. Most ophthalmic drugs, such as pilocarpine, epinephrine, atropine, and local anesthetics, are weak bases. They are typically formulated at an acidic pH to enhance chemical stability. However, this leads to high ionization, reducing their ability to...
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Related Experiment Video

Updated: Feb 25, 2026

Full-Circle Cauterization of Limbal Vascular Plexus for Surgically Induced Glaucoma in Rodents
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Aqueous shunts for glaucoma.

Victoria L Tseng1, Anne L Coleman, Melinda Y Chang

  • 1Stein Eye Institute, UCLA, 100 Stein Plaza, Los Angeles, California, USA, 90025.

The Cochrane Database of Systematic Reviews
|July 28, 2017
PubMed
Summary
This summary is machine-generated.

This review found insufficient evidence to definitively compare aqueous shunts and trabeculectomy for glaucoma. While some evidence suggests the Baerveldt implant may lower intraocular pressure (IOP) more than the Ahmed implant, clinical significance remains unclear.

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Area of Science:

  • Ophthalmology
  • Surgical Interventions
  • Glaucoma Management

Background:

  • Aqueous shunts are utilized to manage intraocular pressure (IOP) in glaucoma patients unresponsive to standard surgical treatments.
  • Glaucoma is a progressive optic neuropathy often associated with elevated IOP, potentially leading to vision loss.

Purpose of the Study:

  • To evaluate the efficacy and safety of aqueous shunts in reducing IOP for glaucoma patients.
  • To compare aqueous shunts against standard surgery, alternative aqueous shunts, or modifications to shunt procedures.

Main Methods:

  • A systematic review and meta-analysis of randomized controlled trials (RCTs) comparing aqueous shunts in glaucoma.
  • Searched multiple databases including CENTRAL, MEDLINE, Embase, PubMed, LILACS, ClinicalTrials.gov, and WHO ICTRP up to August 2016.
  • Included 27 RCTs with 2099 participants, assessing outcomes like IOP, visual acuity, visual fields, medication use, and adverse events.

Main Results:

  • Evidence comparing aqueous shunts to trabeculectomy was of very low to low certainty, with uncertain differences in IOP, visual acuity, and visual fields.
  • The Baerveldt implant showed a trend towards lower IOP compared to the Ahmed implant, but the clinical significance is unclear (moderate-certainty evidence).
  • Data on modifications to aqueous shunts were diverse, with no clear superiority established for specific variations.

Conclusions:

  • Insufficient evidence exists to conclude on the superiority of aqueous shunts over trabeculectomy for glaucoma.
  • Methodological heterogeneity and data quality issues across RCTs limit generalizations about aqueous shunt effectiveness.
  • Further high-quality research is needed to establish definitive comparisons between different aqueous shunt devices and surgical techniques.