Point/Counterpoint
Is Schlemm canal surgery suitable for primary angle-closure glaucoma?
Tang Li, Yuan Huiping, Tang Guangxian, Fan Sujie, Lu Lan, Zhou Minwen, Xie Lin, Nie Xin, Zhang Xiulan
Published 2022-04-10
Cite as Chin J Exp Ophthalmol, 2022, 40(4): 340-344. DOI: 10.3760/cma.j.cn115989-20211102-00598
Abstract
Primary angle-closure glaucoma (PACG) is a common subtype of glaucoma and one of the leading causes of blindness in Asia.Trabeculectomy has been recognized as an effective filtering surgery for PACG and is widely used in clinical practice, but its high risk of postoperative complications, especially bleb scarring over time can not be ignored.Nowadays, non-bleb-based minimally invasive glaucoma surgeries (MIGS) have attracted much attention.Surgeries opening, restoring, or expanding Schlemm canal to reconstruct aqueous humor outflow pathway is one of the MIGS and able to achieve moderate intraocular pressure (IOP) reduction, which has been widely used in the treatment of primary open-angle glaucoma (POAG) for a long time.However, based on the pathogenesis of PACG and its similar pathological changes in Schlemm canal to POAG, some retrospective studies and prospective single-arm studies discovered that Schlemm canal surgery combined with phacoemulsification and/or goniosynechialysis appears to lower IOP well and safe in PACG eyes in recent years.Whether Schlemm canal surgery is also suitable or effective for PACG is getting some attention and is still controversial up to now, mostly due to some differences in pathogenesis between PACG and POAG, it is necessary to perform randomized controlled trials to confirm the efficacy of Schlemm canal surgery for PACG and upgrade the therapeutic strategy of PACG.
Key words:
Primary angle-closure glaucoma; Minimally invasive surgical procedures; Schlemm canal; Intraocular pressure
Contributor Information
Tang Li
Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu 610041, China
Yuan Huiping
Department of Ophthalmology, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
Tang Guangxian
Department of Ophthalmology, Shijiazhuang First Eye Hospital, Shijiazhuang 050000, China
Fan Sujie
Handan Eye Hospital, Handan 056001, China
Lu Lan
Department of Ophthalmology, Fujian Medical University Union Hospital, Fuzhou 350001, China
Zhou Minwen
Department of Ophthalmology, Shanghai General Hospital, Shanghai 200080, China
Xie Lin
Department of Ophthalmology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing 401120, China
Nie Xin
Department of Ophthalmology, Chongqing General Hospital, Chongqing 400014, China
Zhang Xiulan
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
