China has a large burden of primary angle-closure glaucoma (PACG) and the approach to treatment is different from that in most parts of the world. In China, trabeculectomy is a mainstay of initial treatment for PACG and laser peripheral iridotomy is reserved for PAC and PACG with peripheral angle synechiae ≤180 degrees. The greater reduction of and more stable IOP, lower frequency of acute angle closure, decreased progression of peripheral anterior synechia and glaucoma, and the reduction of ocular complications associated with long-term use of glaucoma medications support the use of initial trabeculectomy in PACG without significant lens opacities. Further study is required to determine the indications and effectiveness of initial trabeculectomy for PACG in a developing country setting.
*The Affiliated Eye Hospital, School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang Province
†Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong
‡Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Lab, Beijing, China
§Queensland Eye Institute, University of Queensland, Qld, Australia
Disclosure: The authors declare no conflict of interest.
Reprints: Yuan Bo Liang, MD, PhD, Clinical & Epidemiological Eye Research Center, The Affiliated Eye Hospital of Wenzhou Medical University, No. 270 West College Rd, Wenzhou, Zhejiang 325027, China (e-mail: email@example.com).
Received June 2, 2013
Accepted March 14, 2014