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New developments on the treatment of traumatic angle recession glaucoma
  Release Time:2022/4/29 14:41:35

The team led by Prof. Yuanbo Liang has made new progresses on the treatment of traumatic angle recession glaucoma. The team has published the results of clinical outcomes of a prospective interventional case series on penetrating canaloplasty in patients with traumatic angle recession glaucoma on British Journal of Ophthalmology


According to previous studies, the usual surgical options for patients with traumatic angle recession glaucoma are trabeculectomy with antimetabolite therapy and tube implantation, if conventional medical treatment is unsuccessful. However, the presence of angle recession is a risk factor for failure of filtration surgery independent of age and ethnicity. Moreover, most patients with traumatic glaucoma are young and of working age with a higher risk of failure of trabeculectomy. We have previously reported a novel Schlemm’s canal -based surgery, known as penetrating canaloplasty, which could resolve the problem associated with scarring of the trabecular meshwork caused by angle recession. 


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By evaluating the clinical outcomes of penetrating canaloplasty in traumatic angle recession glaucoma at 1year, it is shown that penetrating canaloplasty significantly reduces IOP and has a high success rate in angle recession glaucoma. 


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Figure: IOP changes


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The glaucoma clinical center of the Eye Hospital is one of the main consultation centers for refractory glaucoma in China. The glaucoma team put great effort on the management of angle-closure glaucoma (ACG), which is a big public health problem in China. Targeting at the restoration of the natural aqueous outflow in ACG eyes, the team introduced the endoscopy and gonioscopy-aided goniosynechialysis as a main surgical strategy for ACG, even in eyes with extensive peripheral synechiae. The glaucoma team provided a novel procedure of penetrating canaloplasty that created a direct conduit from the anterior chamber to the Schlemm canal in the eyes with diffusely closed angle. This procedure has now been successfully utilized in primary ACG, as well as various refractory glaucoma, providing a new option for the management of glaucoma in clinical practice. In addition, the glaucoma team put forward and systematically described the concept of translens pressure difference in the pathogenesis of ACG, based on which, the team innovatively explored the effect of low-dose transscleral cyclophotocoagulation on the treatment of ciliary block-related glaucoma. These strategies greatly changed the concept of clinical management for ACG. What is more, it significantly improved the outcome and quality of life for ACG patients and refractory glaucoma patients.


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