In a patient with primary open-angle glaucoma (POAG) on maximum tolerated medical therapy, which surgical procedure is considered the gold standard first-line surgical intervention?
- A Laser peripheral iridotomy
- B Trabeculectomy with mitomycin-C ✓
- C Cyclodiode laser ablation
- D Express mini-shunt implantation
Correct answer: B. Trabeculectomy with mitomycin-C
Explanation
Trabeculectomy (guarded filtration surgery) with adjunctive mitomycin-C remains the gold standard surgical treatment for POAG when intraocular pressure cannot be controlled medically or when the optic nerve is progressing. The antimetabolite mitomycin-C inhibits fibroblast proliferation at the bleb site, improving long-term bleb survival and IOP control. Laser peripheral iridotomy is the treatment for angle-closure, not POAG.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.