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Related Concept Videos

Angle Closure Glaucoma: Treatment01:28

Angle Closure Glaucoma: Treatment

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...
Open Angle Glaucoma: Treatment01:27

Open Angle Glaucoma: Treatment

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.
Drugs such as carbonic anhydrase inhibitors, α2- and...
Glaucoma: Overview01:25

Glaucoma: Overview

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 Videos

Adjunctive ab-interno goniotomy in chronic angle-closure glaucoma: a retrospective proof-of-concept pilot study using

YuQi Ren1, Xiaojing Zha1,2, YiZheng Zhang3

  • 1Department of Ophthalmology, Shaowu Municipal Hospital, Shaowu, Fujian, China.

Frontiers in Ophthalmology
|July 6, 2026
PubMed
Summary

Adding ab-interno goniotomy to phacoemulsification with goniosynechialysis surgery improved surgical control for chronic angle-closure glaucoma (CACG) patients over 24 months. Individualized treatment benefit predictions require further validation before clinical application.

Keywords:
ab-interno goniotomyanterior segment optical coherence tomographycausal inferencechronic angle-closure glaucomaconditional average treatment effectsdoubly robust learninggoniosynechialysisphacoemulsification

Related Experiment Videos

Area of Science:

  • Ophthalmology
  • Glaucoma Surgery
  • Medical Imaging

Background:

  • Chronic angle-closure glaucoma (CACG) poses significant challenges for intraocular pressure (IOP) management.
  • Phacoemulsification with goniosynechialysis (Phaco-GSL) is a common surgical approach for CACG.
  • Anterior segment optical coherence tomography (AS-OCT) provides detailed anatomical information crucial for surgical planning.

Purpose of the Study:

  • To evaluate the added benefit of ab-interno goniotomy when combined with Phaco-GSL in CACG.
  • To assess if an AS-OCT-informed causal framework can estimate this added benefit.
  • To analyze treatment effect heterogeneity using advanced statistical methods.

Main Methods:

  • A retrospective single-center comparative cohort pilot study involving 102 eyes.
  • Utilized stabilized inverse probability of treatment weighting (IPTW) and augmented inverse probability weighting (AIPW) for marginal treatment effect estimation.
  • Defined medication-free complete success (IOP 5-18 mmHg without medication) and qualified success (IOP 5-18 mmHg with or without medication).

Main Results:

  • Adjunctive goniotomy demonstrated significantly higher 24-month qualified-failure-free survival (68.2% vs 42.5%).
  • Doubly robust estimates favored adjunctive goniotomy for both medication-free complete success (29.1% risk difference) and qualified success (23.3% risk difference).
  • While IOP reduction was modest, medication-free success and reduced medication burden were more apparent with adjunctive goniotomy; hyphema was numerically more frequent.

Conclusions:

  • Adjunctive ab-interno goniotomy appears to improve 24-month surgical outcomes in CACG patients undergoing Phaco-GSL.
  • AS-OCT-informed doubly robust learning shows promise for studying treatment-effect heterogeneity.
  • Current individualized benefit predictions need external validation prior to clinical implementation.