Circumferential Trabeculotomy vs Partial Trabeculotomy: A Systematic Review and Meta-analysis

IntroductIonPrimary open-angle glaucoma (POAG) is a chronic, progressive ocular disease characterized by optic neuropathy, which manifests as acquired atrophy of the optic nerve and loss of retinal ganglion cells and their axons.1 Glaucoma is the leading cause of irreversible blindness worldwide, with projections indicating that 111.8 million people will be affected by 2040.2,3 Furthermore, the proportion of undiagnosed glaucoma cases remains significant and highly prevalent in various communities worldwide, underscoring the critical importance of early detection and timely management to prevent vision loss.4,5 The production of aqueous humor is primarily mediated by the ciliary body and drained through two main pathways: the trabecular meshwork and the uveoscleral pathway, which directs fluid toward the suprachoroidal space.6,7 Dysfunction in trabecular meshwork drainage is a major contributor to the pathogenesis of open-angle glaucoma, as optic neuropathy manifestations arise secondary to elevated intraocular pressure (IOP).[8][9][10] Notably, elevated IOP is the primary risk factor for the onset and progression of glaucoma.11,12 Consequently, the primary objective of glaucoma treatment is to achieve adequate IOP reduction, typically initiated with topical eye drops and/or laser therapy, progressing to more 1,