Abstract: Multichannel aqueous humor drainage surgery through Schlemm canal, suprachoroidal space, deep scleral lake, and subconjunctival filtration jointly promotes aqueous humor outflow and decreases intraocular pressure (IOP), and reduce the incidence of bleb-related complications. The main operations include deep sclerectomy (DS), CO2 laser-assisted sclerectomy surgery (CLASS), penetrating canaloplasty (PCP) and microcatheter-assisted trabeculotomy with deep sclerectomy and trabeculectomy (MATT-DS-Trab). The first two surgical methods retain the inner wall of Schlemm canal and have less interference with the anterior chamber, while the latter two surgical methods combine the excision of trabecular mesh, which overcome the internal and external resistance of Schlemm canal, and achieve good efficacy in the treatment of early and middle glaucoma. Advanced glaucoma requires lower target IOP to protect visual function and prolong visual acuity. This multi-channel aqueous humor drainage surgery provides individualized and precise therapies for patients with advanced glaucoma, improve the success rate of surgery, and reduce the incidence of glaucoma blindness. (Int Rev Ophthalmol, 2023, 47: 6-11)

Key words: glaucoma, multichannel aqueous humor drainage surgery, minimally invasive glaucoma surgery