Trabeculectomy Versus Peripheral Iridectomy Plus Goniotomy in Advanced PACG

This study is comparing two eye surgeries — trabeculectomy (the standard surgery) versus a combination of a simpler procedure (peripheral iridectomy) plus a newer minimally invasive surgery (goniotomy) — for people with advanced primary angle-closure glaucoma (PACG), a type of glaucoma that can cause rapid vision loss. **You may be eligible if...** - You are 45–80 years old - You have advanced primary angle-closure glaucoma with high eye pressure (above 21 mmHg) - Your eye meets specific imaging and pressure criteria confirming advanced disease - You have only mild cataracts with reasonable vision in the study eye **You may NOT be eligible if...** - You have had previous eye surgery or significant eye trauma - You have another type of glaucoma (e.g., open-angle) or retinal disease - You are effectively blind in the other eye (vision worse than 1% in the non-study eye) - Your blood is not clotting properly (INR above 3 if on blood thinners) - You have a serious systemic illness - You are pregnant or breastfeeding Talk to your doctor to see if this trial is right for you.