Ein erhöhter intraokulärer Druck kann zu Schäden am Sehnerv führen und das Sehvermögen
beeinträchtigen. Wenn der Augeninnendruck durch Augentropfen oder Laserbehandlungen
nicht ausreichend gesenkt werden kann, muss eine chirurgische Behandlung in Betracht
gezogen werden, um den Druck zu verringern. Neben der klassischen Glaukomchirurgie
etablieren sich auch minimalinvasive glaukomchirurgische Verfahren, die in diesem
Beitrag vorgestellt werden.
Abstract
Minimally invasive glaucoma surgeries (MIGS) offer an alternative approach, aiming
to be both safe and effective. Defined by their ab interno technique, which avoids
creating a bleb, MIGS procedures seek to reduce intraocular pressure (IOP) by enhancing
the outflow pathways of aqueous humor. Techniques include stenting, incisions, and
excisions of the trabecular meshwork, canaloplasty of Schlemm’s canal, and drainage
implants that enhance uveoscleral outflow to the subchoroidal space. Many of these
methods show promise in reducing intraocular pressure and decreasing the need for
medication. Nevertheless, with the increasing number of these procedures and devices
on the market, it is difficult to keep track of the evidence supporting these methods.
Although randomized controlled trials exist for many of the new MIGS procedures, the
sample sizes are often small, and follow-up periods are limited. Additionally, there
are no randomized controlled trials comparing different MIGS
techniques or MIGS with traditional glaucoma surgery. These factors continue to make
it challenging to select the most appropriate method for each patient. Therefore,
it is essential to persist in conducting randomized controlled long-term studies to
gain a deeper understanding of the applications of MIGS.
Schlüsselwörter
Glaukom - Glaukomchirurgie - minimalinvasive Glaukomchirurgie - Augeninnendruck
Keywords
glaucoma - glaucoma surgery - minimally invasive glaucoma surgery - intraocular pressure
