What surgery would we use to treat open-angle glaucoma?

• A. Trabeculectomy
• B. Tubes/shunts/GDD
• C. MIGs
• D. All of the above

Answer: (D)

Open-angle glaucoma can require surgery when pressure targets aren’t reached with medicines or laser. There are several effective surgical approaches, chosen based on how much pressure reduction is needed, safety considerations, and the eye’s anatomy. Filtration surgery, like trabeculectomy, creates a new drainage pathway to lower intraocular pressure. Glaucoma drainage devices, or tubes/shunts/GDDs, provide an alternative route for aqueous humor to exit the eye, often used when prior surgery or anatomy makes filtration less reliable. Minimally invasive glaucoma surgeries (MIGS) offer less tissue disruption and quicker recovery, giving modest to moderate pressure reduction and are commonly used in earlier disease or alongside cataract surgery. Because all of these strategies can be employed to treat open-angle glaucoma depending on the individual case, the best answer is that all of the above are valid surgical options.