[Focusing on the selection of surgical approaches for open-angle glaucoma].

The rise of minimally invasive glaucoma surgery (MIGS) has brought new options to glaucoma treatment. However, there are significant differences between MIGS and traditional trabeculectomy in terms of surgical philosophy, applicable populations, and long-term efficacy. As a classic procedure, trabeculectomy achieves a well-documented intraocular pressure (IOP)-lowering effect but is associated with a higher risk of complications. In contrast, MIGS features minimal invasiveness and rapid recovery, yet its IOP-lowering magnitude is limited, and its long-term efficacy remains a matter of debate. How to balance these two approaches, especially considering the varying availability of medical resources in China, represents a key challenge for Chinese clinicians. Drawing on the characteristics of Chinese glaucoma patients, the distribution of medical resources, and clinical practice experience, this paper explores in depth the indications, advantages, and limitations of MIGS and trabeculectomy, aiming to provide more targeted references for clinicians in China when selecting glaucoma surgical strategies.