Minimally invasive glaucoma surgery in angle closure.
Chan Nicole Shu-Wen, Sng Chelvin C A
AI Summary
Combining cataract surgery with MIGS for angle-closure glaucoma shows promise for better IOP and medication reduction than cataract surgery alone, offering a safer alternative to traditional surgeries.
Abstract
Purpose of review: This review discusses the evidence on the efficacy, safety and role of minimally invasive glaucoma surgery (MIGS) in eyes with angle closure glaucoma. While cataract surgery remains the most established surgical treatment for primary angle closure glaucoma (PACG), the intraocular pressure (IOP) may remain elevated after cataract surgery despite open angles due to trabecular meshwork damage from chronic iridotrabecular contact.
Recent findings: There is emerging evidence that combining cataract surgery with MIGS in eyes with PACG, though an off-label indication for some MIGS devices, can achieve greater IOP and glaucoma medication reduction than cataract surgery alone.
Summary
Trabecular bypass MIGS procedures and less destructive forms of ciliary body treatment have been shown to be effective in PACG and are safer alternatives to traditional incisional surgeries. Evidence for the use of subconjunctival MIGS and suprachoroidal MIGS in angle closure eyes is lacking at present, and further investigation is indicated.
MeSH Terms
Shields Classification
Key Concepts6
Combining cataract surgery with minimally invasive glaucoma surgery (MIGS) in eyes with primary angle closure glaucoma (PACG) can achieve greater intraocular pressure (IOP) and glaucoma medication reduction than cataract surgery alone, despite some MIGS devices being off-label for this indication.
Trabecular bypass MIGS procedures and less destructive forms of ciliary body treatment have been shown to be effective in primary angle closure glaucoma (PACG).
Trabecular bypass MIGS procedures and less destructive forms of ciliary body treatment are safer alternatives to traditional incisional surgeries for primary angle closure glaucoma (PACG).
Evidence for the use of subconjunctival MIGS and suprachoroidal MIGS in angle closure eyes is currently lacking, and further investigation is indicated.
Cataract surgery remains the most established surgical treatment for primary angle closure glaucoma (PACG).
Despite open angles after cataract surgery, intraocular pressure (IOP) may remain elevated in primary angle closure glaucoma (PACG) due to trabecular meshwork damage from chronic iridotrabecular contact.
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