Goniotomy and phacogoniotomy in glaucoma surgery

Goniotomy (GT) or ab interno trabeculotomy facilitates aqueous humor drainage thereby resulting intraocular pressure (IOP) reduction by incising the trabecular meshwork and the inner wall of Schlemm's canal. It can be performed alone or combined with cataract surgery, a procedure known as phacogoniotomy. As these procedures can be performed with non-device built instruments compared to other minimally invasive glaucoma surgery (MIGS) devices or procedures, they are increasingly adopted in low- and middle-income countries (LMICs) and primary-level hospitals. To summarize the clinical use and future directions of GT and phacogoniotomy, we conducted a comprehensive literature review by searching PubMed. The available evidence suggests that GT and phacogoniotomy are effective and safe procedures, providing a widely adopted surgical option applicable to glaucoma patients of all ages.