Abstract: Nanophthalmos with secondary angle-closure glaucoma (NSACG) carries significant surgical risks, including malignant glaucoma, uveal effusion, and even suprachoroidal hemorrhage. To address the complex pathogenesis of NSACG and its underlying pathophysiological mechanisms leading to severe complications, we developed a modular surgical strategy targeting three core factors: anterior segment dysgenesis, angle closure, and uveal effusion. This integrated approach combines: phacoemulsification with intraocular lens implantation (Phaco-IOL), irido-zonulo-hyaloid-vitrectomy (IZHV), goniosynechialysis (GSL) or Ahmed glaucoma valve (AGV) implantation, and sclerotomy with scleral window. By selectively tailoring these surgical components according to individual ocular characteristics, we provide personalized modular surgical management for this refractory glaucoma subtype. This strategy aims to reduce surgical complication risks and improve long-term outcomes.

Key words:  Nanophthalmos, Angle-closure glaucoma/secondary, Malignant glaucoma, Uveal effusion