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Related Concept Videos

Open Angle Glaucoma: Treatment01:27

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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: Treatment01:28

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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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Updated: Aug 7, 2025

Full-Circle Cauterization of Limbal Vascular Plexus for Surgically Induced Glaucoma in Rodents
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Device-modified trabeculectomy for glaucoma.

Junghyun Park1, Thanitsara Rittiphairoj2, Xue Wang3

  • 1Department of Ophthalmology, Inje University Seoul Paik Hospital, Seoul, Korea, South.

The Cochrane Database of Systematic Reviews
|March 13, 2023
PubMed
Summary
This summary is machine-generated.

Device-modified trabeculectomy shows potential for improved intraocular pressure (IOP) control and reduced cataract surgery risk in glaucoma patients. However, evidence for specific devices like Ex-PRESS and PreserFlo MicroShunt has limitations, necessitating further research.

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Area of Science:

  • Ophthalmology
  • Surgical Innovation
  • Glaucoma Management

Background:

  • Glaucoma is a leading cause of irreversible blindness worldwide, characterized by optic neuropathy and vision loss.
  • Current treatments aim to reduce intraocular pressure (IOP) through medications, laser, or surgery, with trabeculectomy being a common incisional approach.
  • Device-modified trabeculectomy techniques aim to enhance the safety and durability of bleb-forming surgery, but their comparative effectiveness remains unclear.

Purpose of the Study:

  • To evaluate the benefits and harms of various devices used adjunctively with trabeculectomy for IOP control in glaucoma patients.
  • To compare device-modified trabeculectomy against standard trabeculectomy in terms of efficacy and safety outcomes.

Main Methods:

  • A systematic review and meta-analysis of randomized controlled trials (RCTs) comparing device-modified trabeculectomy with standard trabeculectomy.
  • Cochrane search methods were employed, with the latest search conducted in August 2021.
  • Primary outcomes included change in IOP and mean postoperative IOP at one year; secondary outcomes covered visual acuity, visual fields, quality of life, and complications.

Main Results:

  • Seven studies (Ex-PRESS device) and one study (PreserFlo MicroShunt) involving 961 participants were included. Evidence quality was often low to moderate due to poor reporting and risk of bias.
  • Ex-PRESS plus trabeculectomy showed a potential for slightly lower one-year IOP (MD -1.76 mmHg) compared to standard trabeculectomy.
  • PreserFlo MicroShunt may result in slightly higher one-year IOP (MD 3.20 mmHg) but may reduce the risk of hypotony and shallow anterior chamber.
  • Device-modified trabeculectomy was associated with less subsequent cataract surgery within one year.

Conclusions:

  • Ex-PRESS plus trabeculectomy may offer greater IOP reduction, but evidence certainty is low. PreserFlo MicroShunt may be less effective for IOP lowering but safer regarding hypotony.
  • Device-modified trabeculectomy generally appears to reduce the risk of needing cataract surgery post-operatively.
  • Limitations in study design and conduct restrict the applicability of findings; further research is needed for diverse populations and glaucoma types.