Ang Bryan Chin Hou, Lim Sheng Yang, Betzler Bjorn Kaijun, Wong Hon Jen, Stewart Michael W, Dorairaj Syril
Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore 308433, Singapore.
Department of Ophthalmology, National Healthcare Group Eye Institute, Woodlands Health Campus, Singapore 737628, Singapore.
Bioengineering (Basel). 2023 Sep 19;10(9):1096. doi: 10.3390/bioengineering10091096.
Surgery has long been an important treatment for limiting optic nerve damage and minimising visual loss in patients with glaucoma. Numerous improvements, modifications, and innovations in glaucoma surgery over recent decades have improved surgical safety, and have led to earlier and more frequent surgical intervention in glaucoma patients at risk of vision loss. This review summarises the latest advancements in trabeculectomy surgery, glaucoma drainage device (GDD) implantation, and minimally invasive glaucoma surgery (MIGS). A comprehensive search of MEDLINE, EMBASE, and CENTRAL databases, alongside subsequent hand searches-limited to the past 10 years for trabeculectomy and GDDs, and the past 5 years for MIGS-yielded 2283 results, 58 of which were included in the final review (8 trabeculectomy, 27 GDD, and 23 MIGS). Advancements in trabeculectomy are described in terms of adjunctive incisions, Tenon's layer management, and novel suturing techniques. Advancements in GDD implantation pertain to modifications of surgical techniques and devices, novel methods to deal with postoperative complications and surgical failure, and the invention of new GDDs. Finally, the popularity of MIGS has recently promoted modifications to current surgical techniques and the development of novel MIGS devices.
长期以来，手术一直是限制青光眼患者视神经损伤和减少视力丧失的重要治疗方法。近几十年来，青光眼手术的众多改进、改良和创新提高了手术安全性，并导致对有视力丧失风险的青光眼患者进行更早、更频繁的手术干预。本综述总结了小梁切除术、青光眼引流装置（GDD）植入术和微创青光眼手术（MIGS）的最新进展。对MEDLINE、EMBASE和CENTRAL数据库进行全面检索，随后进行手工检索——小梁切除术和GDD检索过去10年，MIGS检索过去5年——共得到2283条结果，其中58条纳入最终综述（8条小梁切除术、27条GDD和23条MIGS）。小梁切除术的进展从辅助切口、眼球筋膜囊层处理和新型缝合技术方面进行了描述。GDD植入术的进展涉及手术技术和装置的改良、处理术后并发症和手术失败的新方法以及新型GDD的发明。最后，MIGS的普及最近推动了当前手术技术的改良和新型MIGS装置的开发。
