Modified suture-assisted penetrating canaloplasty vs. compound trabeculectomy in treating primary angle-closure glaucoma

Modified SAPC provides effective and sustained IOP reduction with a favorable safety profile, outperforming compound trabeculectomy in PACG patients over 12 months. while minimizing medication dependence, demonstrating superior effectiveness to compound trabeculectomy with a favorable short-term safety profile. Why carry out this study? 1. This study aimed to evaluate the effectiveness and safety of a modified suture-assisted penetrating canaloplasty (SAPC) technique compared to compound trabeculectomy in treating primary angle-closure glaucoma (PACG). 2. This study addressed the limitations of high-cost microcatheters and bleb-related complications. What was learned from the study? 1. Modified SAPC demonstrated superior intraocular pressure (IOP) reduction (12.38±2.60 mmHg vs. 16.82±2.36 mmHg at 12 months) and higher complete success rates (89.47% vs. 52.94%) compared to compound trabeculectomy, with fewer complications and reduced dependence on postoperative medications. 2. The technique's cost-effective use of 5-0 polypropylene sutures and adjustable sutures simplified the procedure while maintaining high catheterization success (87.5%), offering a viable alternative for mild-to-moderate PACG. 3. Younger patients with short axial lengths showed an increased risk of malignant glaucoma post-SAPC, highlighting the need for refined surgical approaches in this subgroup.