الفهرس 
Overview on Management of Primary Open Angle GlaucomaOnly 14 pages are availabe for public view
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Abstract
Glaucoma is a leading cause of permanent blindness worldwide, affecting about 2-3% of people above the age of 40, yet around half of them remain undetected.
Open angle glaucoma comprises a multifactorial disease characterized by loss of retinal ganglion cells that leads to a distinctive optic neuropathy and associated visual field loss. Elevated intraocular pressure (IOP) is considered the principal risk factor for the development and progression of glaucomatous neuropathy.
Reduction in intraocular pressure is the only treatable risk factor for glaucoma and may be achieved by either medical, laser or surgical intervention.
SST is the gold standard surgery for reducing IOP in patients with glaucoma, where after raising a conjunctival flap, a fistula is made between the anterior chamber and the subconjunctival space under a scleral flap leading to aqueous humor drainage and subsequent bleb formation
The rates of success and specific complications with trabeculectomy are widely known. A big disadvantage of trabeculectomy is the need for a conjunctival peritomy and subconjunctival dissection. Creation of either a limbal- or fornix-based conjunctival flap for any kind of procedure invariably induces sub-conjunctival fibrosis which can lead on to filtration failure secondary to scarring.
SIGS was developed by Dr. Soosan Jacob in 2014 in an effort to avoid many of the trabeculectomy disadvantages while simultaneously making filtration surgery easier, faster, less traumatic, & more likely to succeed. A 2.8-mm bevel-up keratome is used to fashion a sclero-corneal tunnel in a single step & then intentionally compromise the tunnel by punching the posterior corneal lip.