Purpose of review 

Minimally invasive glaucoma surgery (MIGS) has been shown to be safe and effective in treatment of mild to moderate glaucoma in adults, but reports in childhood glaucoma are limited. We review the available data concerning MIGS and discuss its potential role in childhood glaucoma management.

Recent findings 

Ab interno counterparts to circumferential ab externo trabeculotomy such as gonioscopy-assisted transluminal trabeculotomy (GATT) and Trab360 show promise in treatment of primary glaucomas as reported in a few retrospective case series. Kahook Dual Blade (KDB) and Trabectome have demonstrated mixed results in few published case reports in children. Small case series and reports suggest that the Xen gel stent can be a safer alternative to traditional filtration surgery, though data on long-term implant and bleb stability are unavailable. Newer devices are being investigated and early results are encouraging.

Summary 

GATT and Trab360 seem to be safe, effective methods of achieving circumferential trabeculotomy in childhood glaucoma. KDB, Trabectome, and Xen gel stent have shown some success in selected cases with short-term follow-up. Surgeons must determine the risks and benefits of MIGS over more established methods of intraocular pressure reduction for each individual child. Further research is needed to validate initial findings regarding MIGS in childhood glaucoma.

中文翻译：

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儿童青光眼的微创青光眼手术

审查目的 

微创青光眼手术（MIGS）已被证明对于治疗成人轻至中度青光眼是安全有效的，但针对儿童青光眼的报道有限。我们回顾了有关 MIGS 的现有数据，并讨论了其在儿童青光眼治疗中的潜在作用。

最近的发现 

与环外小梁切开术相对应的内外小梁切开术，如房角镜辅助经腔内小梁切开术 (GATT) 和 Trab360，在一些回顾性病例系列中报道，显示出治疗原发性青光眼的前景。Kahook Dual Blade (KDB) 和 Trabectome 在少数已发表的儿童病例报告中显示出不同的结果。小病例系列和报告表明，Xen 凝胶支架可以成为传统滤过手术的更安全的替代方案，尽管无法获得长期植入和滤泡稳定性的数据。较新的设备正在接受研究，早期结果令人鼓舞。

概括 

GATT 和 Trab360 似乎是在儿童青光眼中实现环形小梁切开术的安全、有效的方法。KDB、Trabectome 和 Xen 凝胶支架在短期随访的选定病例中取得了一些成功。外科医生必须确定 MIGS 相对于每个儿童更成熟的眼内压降低方法的风险和益处。需要进一步的研究来验证有关儿童青光眼 MIGS 的初步研究结果。