The aim of this study was to analyze the change trend of glaucoma surgery in Beijing Tongren Hospital from January 2009 to July 2019.

It was a cross-sectional observational study. 8581 cases of glaucoma inpatients (8581 eyes), aged from 1 to 94 years old, in Beijing Tongren Hospital were enrolled from January 2009 to July 2019, including 4442 males and 4139 females.The average age was 5(0.4±24.7) years old. According to the clinical diagnosis, the subjects included were further divided into angle-closure glaucoma, open-angle glaucoma, and developmental glaucoma. The number of subjects inangle-closure glaucoma was 4471. The number of subject in open-angle glaucoma was 2530. The number of developmental glaucoma was 1580 (73.2% of developmental glaucomapatients with congenital glaucoma). Glaucoma surgeries were divided into external drainage surgeries with conjunctival filtration bleb as the main method of reducing intraocular pressure and internal drainage surgeries to promote drainage of aqueous humor through physiological pathway and non-drainage surgery. Non-drainage surgery was defined as cyclodestructive procedures as well as single cataract extraction combined with intraocular lens implantation. The external drainage surgery was further divided into external drainage surgery group A and external drainage surgery group B. The external drainage surgery group A was for trabeculectomy. The external drainage surgery group B was external drainage implant surgery, including tube, Ahmed glaucoma valve implant, and Ex-PRESS implant surgery. The internal drainage surgery was divided into internal drainage surgery group A and internal drainage surgery group B. The operation of internal drainage surgery group A mainly focus on schlemm's canal and trabecular meshwork, including trabeculotomy, goniotomy, canaloplasty and trabectome; internal drainage surgery group B includes goniosynechialysis, gonioplasty, peripheral iridotomy, endocyclophotocoagulation and laser trabeculoplasty. Cochran-Armitage trend test were used to analyze the change of surgical methods in three types of glaucoma.

The number of angle-closure glaucoma for external drainage was 263(83.4%)in 2009, and decreased to 89 (30.6%) in 2019, while the number of internal drainage surgery increased from 45 (14.3%) in 2009 to 201 (69.1%) in 2019. The number of open-angle glaucoma for external drainage was 130 (100%) in 2009 and was 82 (38.8%) in 2019, while the number of internal drainage surgery increased from zero in 2009 to 124 (60.2%) in 2019. The number of developmental glaucoma for external drainage was 39 (95.2%) in 2009 and was 47 (32.6%) in 2019, while the number of internal drainage surgery increased from 1 (2.4%) in 2009 to 95 (66.0%) in 2019. From January 2009 to July 2019, the proportion of external drainage operations significantly decreased year by year (Z=2.102, 2.183, 3.053; P_trend<0.05), the proportion of internal drainage surgery remarkably increased year by year (Z=2.311, 2.609, 3.612; P_trend<0.05) in angle-closure glaucoma, open-angle glaucoma, and developmental glaucoma.

In the past ten years, the methods of glaucoma surgery in our hospital has gradually changed. The surgical methods of angle-closure glaucoma, open-angle glaucoma, and developmental glaucoma have all changed from external drainage operations to internal drainage operations.