[关键词]
[摘要]
青光眼是全球首位不可逆性致盲性眼病，通过手术降低眼压是治疗开角型青光眼(OAG)的重要手段。近年来微创青光眼手术(MIGS)逐渐兴起，为青光眼的治疗提供了更多选择。基于小梁网-Schlemm管途径的MIGS作用于房水流出的主要途径，对眼部正常解剖结构的损伤较小，逐渐成为主流手术。根据作用机制主要分为小梁网切开类、小梁网旁路类和Schlemm管扩张类三种类型，代表术式和装置有内路房角镜下微导管/缝线辅助的全周小梁切开术(GATT)、微导管/缝线辅助下360°外路小梁切开术(MAT)、小梁消融术、双刃刀(KDB)、谷户钩(TMH)、准分子激光小梁切开术(ELT)、iStent系列、Hydrus微支架植入术、内路Schlemm管成形术(ABiC)、穿透性Schlemm管成形术(PCP)、新型微创内路三联(3T)手术。文章回顾了目前基于小梁网-Schlemm管途径的MIGS在OAG中应用的文献，旨在对此类MIGS治疗OAG的作用原理、有效性和安全性进行综述，并对各术式的优缺点进行总结，以期为OAG手术治疗的选择和临床研究提供参考。
[Key word]
[Abstract]
Glaucoma is the leading cause of irreversible blindness worldwide. Reducing intraocular pressure through surgical interventions is a crucial approach for managing open-angle glaucoma(OAG). In recent years, minimally invasive glaucoma surgeries(MIGS)have gained prominence, providing a lot of options for the treatment of glaucoma. MIGS that target the trabecular meshwork-Schlemm's canal pathway act on the main pathway of aqueous humor outflow with less damage to the normal anatomical structures of the eye, and are gradually becoming the mainstream procedures. These surgeries can be categorized into three main types based on their mechanisms of action: trabeculotomy, trabecular meshwork bypass, and Schlemm's canal dilation. Representative procedures and devices include gonioscopy-assisted transluminal trabeculotomy(GATT), microcatheter-assisted trabeculotomy(MAT), Trabectome, kahook dual blade(KDB), tanito microhook(TMH), excimer laser trabeculotomy(ELT), iStent series, Hydrus, ABiC, PCP and 3T procedures. This article reviews the current literature on the application of MIGS targeting the trabecular meshwork-Schlemm's canal pathway in OAG. It aims to discuss the principles, efficacy and safety of such MIGS for the treatment of OAG, and to summarize the advantages and disadvantages of each procedure, with a view to informing the choice of surgical treatment and clinical research for OAG.
[中图分类号]
[基金项目]
西安市人民医院(西安市第四医院)孵化基金项目(No.2022LBSH10)
