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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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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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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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Related Experiment Video

Updated: Nov 17, 2025

Ultrasound Cyclo Plasty in Eyes with Glaucoma
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Ab interno trabecular bypass surgery with Trabectome for open-angle glaucoma.

Kuang Hu1, Anupa Shah2, Gianni Virgili3,4

  • 1Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK.

The Cochrane Database of Systematic Reviews
|February 13, 2021
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Summary

This study found no high-quality evidence on the efficacy and safety of ab interno trabecular bypass surgery with Trabectome for open-angle glaucoma. More well-designed randomized controlled trials are needed to assess long-term outcomes.

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Area of Science:

  • Ophthalmology
  • Surgical Innovation
  • Glaucoma Management

Background:

  • Glaucoma is a leading cause of irreversible blindness worldwide.
  • Minimally invasive glaucoma surgery (MIGS) techniques, including ab interno trabecular bypass surgery, aim to prevent glaucoma progression.
  • The Trabectome device is a MIGS technique used for open-angle glaucoma.

Purpose of the Study:

  • To critically evaluate the evidence for the efficacy and safety of ab interno trabecular bypass surgery with the Trabectome device.
  • To assess the benefits of Trabectome surgery for patients with open-angle glaucoma.

Main Methods:

  • A systematic search was conducted across multiple databases (CENTRAL, MEDLINE, Embase, ISRCTN, ClinicalTrials.gov, WHO ICTRP) up to July 17, 2020.
  • Included were randomized controlled trials (RCTs) comparing Trabectome surgery to other surgical treatments, laser, or medical therapy.
  • Primary outcomes included medication-free status and intraocular pressure (IOP) reduction; secondary outcomes included further surgery, quality of life, and adverse events.

Main Results:

  • One small, single-center RCT (19 participants) was included, which was terminated early and assessed as having a high risk of bias.
  • Evidence regarding medication-free status and IOP reduction was of very low certainty, with unclear or imprecise estimates.
  • Postoperative complications were noted in both intervention and comparator groups, with very low-certainty evidence.

Conclusions:

  • There is a lack of high-quality evidence to support the efficacy and safety of Trabectome surgery for open-angle glaucoma.
  • Further well-designed randomized controlled trials are necessary to determine the long-term outcomes of this surgical technique.