Trabeculectomy

Surgery

Ophthalmology

Glaucoma

Blindness

Glaucoma surgery

Implant

Intraocular pressure

Trabecular meshwork

Medicine

Optometry

Glaucoma is a progressive optic neuropathy that is the second leading cause of preventable blindness worldwide, after cataract formation. A rise in the intraocular pressure (IOP) is considered to be a major risk factor for glaucoma and is associated with an abnormal increase of resistance to aqueous humour outflow from the anterior chamber. Glaucoma drainage devices have been developed to provide an alternative pathway through which aqueous humour can effectively exit the anterior chamber, thereby reducing IOP. These devices include the traditional aqueous shunts with tube-plate design, as well as more recent implants, such as the trabeculectomy-modifying EX-PRESS® implant and the new minimally invasive glaucoma surgery (MIGS) devices. In this review, we will describe each implant in detail, focusing on their efficacy in reducing IOP and safety profile. Additionally, a critical and evidence-based comparison between these implants will be provided. Finally, we will propose potential developments that may help to improve the performance of current devices.摘要: 青光眼是一种进行性视神经病变, 为全球仅次于白内障的第二大可预防性致盲性眼病。眼压 (IOP) 升高被认为是青光眼的主要危险因素, 并与前房房水流出阻力的异常增加有关。青光眼引流装置为房水有效地排出前房提供了一种新的途径, 从而降低眼压。这些装置包括传统的具有管板设计的房水分流器, 以及最新的植入物, 如小梁切除术改良EX-PRESS®植入物和新的微创青光眼手术 (MIGS) 装置。在这篇综述中, 我们将详细描述每种植入物, 并重点介绍它们在降低眼压和安全性方面的功效。此外, 本文对这些植入物进行关键的循证的比较。最后, 我们将提出有助于改善现有装置的性能进行潜在改善的建议。.

Conventional glaucoma implants and the new MIGS devices: a comprehensive review of current options and future directions