On January 9, 2026, the 11th Annual Meeting of Medical Scientists was grandly convened in Beijing. The conference unveiled two prestigious lists: the "2025 Top Ten Innovative Medical Experts in China" and the "2025 Top Ten Original Advances in Ophthalmology in China".

Zhongshan Ophthalmic Center (ZOC) achieved remarkable recognition across multiple categories:

• Prof. LI Tao was successfully selected as a "2025 Top Ten Innovative Medical Expert".
• The "High-Precision Remote Ophthalmic Surgical Robot" technology, independently innovated by Prof. LIN Haotian’s team, was listed among the Top Ten Original Advances (New Clinical Equipment). 
• The project "Non-device-based Goniotomy and Phacogoniotomy in Glaucoma”, led by Prof. ZHANG Xiulan, was successfully selected as a Top Ten Original Advance (New Clinical Technology).

This achievement marks a major breakthrough in the treatment of blinding eye diseases in China. Prof. Zhang’s system provides a high-quality, indigenous "Chinese solution" for glaucoma management.

Project Introduction

Glaucoma is the leading cause of irreversible blindness worldwide. While traditional surgeries such as trabeculectomy (and combined phacotrabeculectomy) are effective, they are complex and carry high complication rates. Minimally Invasive Glaucoma Surgery (MIGS) introduced a new treatment paradigm, but often relies on expensive implants. Leading a collaboration with over ten domestic institutions, Prof. Zhang Xiulan pioneered a non-device-based Goniotomy and Phacogoniotomy system. This innovative approach is reliable, efficient, and consumable-free, significantly reducing complications and simplifying surgical procedures.

In 2025, the team published two high-impact randomized controlled trials (RCTs) in JAMA Ophthalmology. These studies confirmed that for advanced primary angle-closure glaucoma (PACG): 1) Phacogoniotomy (Phaco + GSL + GT) is non-inferior to traditional Phacotrabeculectomy^1-2; 2) Surgical Peripheral Iridectomy (SPI) combined with GSL and GT is non-inferior to standard trabeculectomy³. Both methods demonstrated fewer complications and superior patient-reported quality of life, establishing them as preferred options for advanced PACG.

Figure 1. The non-device-based Goniotomy and Phacogoniotomy treatment system covers five surgical combinations, applicable to all age groups and all types of glaucoma^4-17

The global impact of this work has been profound, highlighted by supportive editorials in JAMA Ophthalmology¹⁸ and Asia-Pacific Journal of Ophthalmology¹⁹. The American Glaucoma Society (AGS) featured these findings in its 40th Anniversary Special Issue as a "Seminal Study in Angle-Closure Glaucoma over the past two decades"²⁰, recognizing it as a major breakthrough in PACG management. This research series was also honored as the Journal of Glaucoma "Paper of the Month" in 2025⁶. Furthermore, the Asia-Pacific Glaucoma Society (APGS) 2024 newsletter described the work as "Revolutionizing PACG Treatment with MIGS"^23-24.

The system achieves original breakthroughs across the entire innovation cycle, from theoretical research and standardized technical protocols to instrument translation. Spanning five years of clinical research through December 2025, the project has yielded 50 academic achievements, including 38 high-quality peer-reviewed papers, 6 expert consensus recommendations, 3 commercialized patents for MIGS devices (the LAN series), and 2 books authored by the team and published by the People’s Medical Publishing House: Illustrated Surgical Techniques and Pearls of MIGS (2022) and Illustrated Anterior Segment Examinations and Diagnosis of Glaucoma (2020).

These surgical techniques have been incorporated into the Chinese Primary Angle-Closure Glaucoma Consensus (2025)²¹ and the APGS/AAPPO Acute Primary Angle Closure Attack Consensus (2025)²². The system was recognized as a "Guangzhou Clinical High-Tech Project" (Project Number: 2026P-GX005) and one of the "Top Ten Original Advances in Ophthalmology in China," establishing a new industry benchmark. Clinical practice has fully demonstrated the immense value of these procedures, marking a revolutionary breakthrough in PACG management

Contributors: ZHANG Xiulan, WANG Ningli, FAN Sujie, TANG Li, XIE Lin, TANG Guangxian, YUAN Huiping, LU Lan, NIE Xin, ZHOU Minwen.

Reference:

1. Song Y#, Lin F#, Lv A, Zhang Y, Lu L, Xie L, Tang G, Yuan H, Yang Y, Xu J, Lu P, Xiao M, Zhu X, Yan X, Song W, Li X, Zhang H, Li F, Wang Z, Jin L, Gao X, Liang X, Zhou M, Zhao X, Zhang Y, Chen W, Wang N, Tham CC, Barton K, Park KH, Aung T, Weinreb RN, Tang L*, Fan S*, Lam DSC*, Zhang X*. Phacogoniotomy versus phacotrabeculectomy for advanced primary angle-closure glaucoma with cataract: a randomized non-inferiority trial. Asia Pac J Ophthalmol (Phila). 2023 Dec; 26:100033.
2. Song Y#, Fan S#, Tang L#, Lin F, Li F, Lv A, Li X, Wen T, Lu L, Xiao M, Xie L, Zhu X, Tang G, Zhang H, Yan X, Yuan H, Song W, Yang Y, Xu J, Zhou F, Wang Z, Jin L, Liang X, Zhou M, Zhao X, Chen W, Park KH, Barton K, Aung T, Tham CC, Lam DSC, Weinreb RN, Wang N*, Zhang X*; PVP Study Group. Two-year outcomes of phacogoniotomy vs phacotrabeculectomy for advanced primary angle-closure glaucoma with cataract: a noninferiority randomized clinical trial. JAMA Ophthalmol. 2025 Jun 1;143(6):462-469.
3. Lin F#, Lv A#, Li F#, Song Y, Xie L, Zhu X, Tang L, Zhang Y, Huang J, Tang G, Zhang H, Lu L, Xiao M, Xu J, Nie X, Liao M, Yang Y, Gao K, Yuan H, Song W, Zuo C, Lu P, Yan X, Zhou F, Wang Z, Jin L, Peng Y, Chen W, Barton K, Park KH, Aung T, Lam DSC, Weinreb RN, Wang N, Tham CC, Fan S*, Zhang X*; TVG study group. Peripheral iridectomy with goniosynechialysis and goniotomy vs trabeculectomy for advanced PACG: a randomized clinical trial. JAMA Ophthalmol. 2025 Jun 1;143(6):472-479.  
4. Zhang Y#, Yu P#, Zhang Y, Sugihara K, Zhu X, Zhang Y, Yang X, Li X, Liu Y, Zhang H, Yan X, Zhang H, Lin F, Song Y, Gao X, Yuan H, Tang G, Zhou W, Fan S, Dang G, Tang L, Chen W, Wang N, Park KH, Barton K, Aung T, Lam DSC, Weinreb RN, Xie L, Tanito M, Zeng L*, Zhang X*. Influence of goniotomy size on treatment safety and efficacy for primary open-angle glaucoma: a multicenter study. Am J Ophthalmol. 2023 Dec; 256:118-125.
5. Song Y#, Zhu X#, Zhang Y, Shu J, Dang G, Zhou W, Sun L, Li F, Lin F, Zhang Y, Liang X, Wang Z, Zhang Y, Zhang Y, Chen W, Zeng L, Tang L*, Xie L, Lam DSC, Wang N, Barton K, Weinreb RN, Zhang X*. Outcomes of partial versus complete goniotomy with or without phacoemulsification for primary open angle glaucoma: a multicenter study. J Glaucoma. 2023 Jul;32(7):563-568.
6. Song Y#, Ye X#, Yang M#, Zhang Z#, Zeng L, Fan H, Xie L, Zhu X, Zhang H, Feng Y, Xu J, Ke M, Bao Q, Pan X, Ge Q, Lin F, Yang Z, Fang Z, Wang Z, Xiaokaiti D, Fan S*, Fan N*, Qi Y*, Zhang X*; ECO study group. Outcomes of phacogoniotomy for medically-controlled and uncontrolled primary open-angle glaucoma with cataract: a multicenter study. J Glaucoma. 2025 Aug;34(8):591-597.
7. Yang Z#, Wang Z#, Fan H#, Ge Q#, Dang G, Yang X, Xie L, Zhu X, Yang Y, Wang Y, Liu J, Zhang H, Feng Y, Qi Y, Ye X, Lai M, Lin P, Wang P, Han S, Xu J, Tao L, Liu H, Nie X, Liao M, Zou K, Jiang Y, Song Y, Lin F, Zhou F, Xiaokaiti D, Liu X, Fang Z, Jin L, Chen Y, Tham CC, Han Y, Pan X*, Zeng L*, Weinreb RN*, Zhang X*. Outcome of goniotomy over 120°, 240°, and 360° in juvenile open-angle glaucoma: a multicenter study. J Glaucoma. 2025;34(6):433-439.
8. Lin F#, Li L#, Xiaokaiti D#, Fan S, Zhang Z, Yang Y, Tang G, Zhang H, Li Y, Song Y, Wang Z, Fang Z, Xu J*, Zhang X*. Two-year outcomes of goniotomy after failed surgery for glaucoma: a multicenter study. Ophthalmol Sci. 2025 Aug 20;6(1):100922.
9. Lin F#, Nie X#, Shi J, Song Y, Lv A, Li X, Lu P, Zhang H, Jin L, Tang G, Fan S, Weinreb RN*, Zhang X*. Safety and efficacy of goniotomy following failed surgery for glaucoma. J Glaucoma. 2023 Nov;32(11):942-947.
10. Lin F#, Zhang Y#, Zhu X#, Yu P#, Fan S, Lv A, Li X, Tang L, Zhang Y, Tang G, Yan X, Lu L, Xiao M, Yuan H, Song W, Zhou M, Zhao X, Nie X, Liao M, Song Y, Wang Z, Chen W, Barton K, Park KH, Aung T, Lam DSC, Weinreb RN, Tham CC, Zeng L*, Xie L*, Wang N*, Zhang X*. Impact of peripheral anterior synechiae on the outcome of combined phacoemulsification, goniosynechialysis and goniotomy for primary angle-closure glaucoma and cataract: a multicenter observational study. J Glaucoma. 2024 Aug 1;33(8):587-593.
11. Song Y#, Tang L#, Fan F#, Zhu X#, Lv A#, Wen T, Tang G, Zhang H, Yuan H, Song W, Zhou M, Zhao X, Li F, Lin F, Wang Z, Fang Z, Liang X, Wang Z, Jin L, Zhou F, Chen W, Lam DS, Tham CC, Park KH, Barton K, Wang N, Weinreb RN, Fan S*, Xie L*, Aung T*, Zhang X*, for the PVP study group. Four-year outcome of phacogoniotomy for advanced primary angle-closure glaucoma with cataracts: a multicenter study. Ophthalmology Glaucoma. 2025 (revision, published recently).
12. Song Y#, Xie L#, Zhu X, Fan S, Lv A, Tang G, Zhang H, Tang L, Zhang Y, Lu L, Xiao M, Yuan H, Song W, Zhou M, Zhao X, Wang Z, Lin F, Liang X, Peng Y, Chen Y, Wang Z, Jin L, Park KH, Barton K, Chen W, Wang N, Han Y, Lam D, Weinreb R, Aung T, Tham CC*, Zhang X*; PVP study group. Two-year outcome of phacogoniotomy for advanced primary angle-closure glaucoma with cataracts: a multicentre study. Br J Ophthalmol. 2025 Mar 6:bjo-2024-325375.
13. Song Y#, Zhang Y#, Li F, Zhang Y, Lin F, Lv A, Li X, Lu P, Xiao M, Zhang H, Yan X, Zhu X, Song W, Zhao X, Gao X, Hu K, Liang X, Zhang X, Wang Z, Shi J, Zhu Y, Zhang Y, Fan S, Tang G, Lu L, Xie L, Yuan H, Zhou M, Chen W, Tang L*, Lam DSC, Weinreb RN, Zhang X*, and on behalf of PVP Study Group. One-year results of a multicenter study: intraocular pressure-lowering effect of combined phacoemulsification, goniosynechialysis, and goniotomy for cases of advanced primary angle-closure glaucoma with cataract. Asia Pac J Ophthalmol (Phila). 2022 Nov11(6)(2022): 529-535.
14. Song Y#, Zhang Y, Lin F, Nie X, Shi J, Chen T, Liang X, Wang Z, Wei M, Chen S, Zhang X*. Outcomes and safety of phacoemulsification combined with intraocular lens implantation plus goniosynechialysis and goniotomy for advanced primary angle-closure glaucoma. Chin J Exp Ophthalmol. 2022 Apr, 40(04):334-339.
15. Lin F#, Li L#, Lu P#, Tang L, Zhang Y, Xie L, Zhu X, Tang G, Zhang H, Lu L, Xiao M, Xu J, Song Y, Peng Y, Li X, Chen W, Zhou F, Wang N, Barton K, Park KH, Aung T, Weinreb RN, Tham CC, Lam DSC, Fan S*, Han Y*, Zhang X*; TVG study group. Two-year outcomes of combined surgical peripheral iridectomy, goniosynechialysis, and goniotomy for advanced primary angle-closure glaucoma without cataract: A multicenter study. Asia Pac J Ophthalmol (Phila). 2025 Feb 26:100166.
16. Gao X#, Lin F#, Lu P#, Xie L, Tang L, Zhu X, Zhang Y, Lv A, Tang G, Zhang H, Yan X, Song Y, Xu J, Huang J, Zhang Y, Hu K, Peng Y, Wang Z, Li X, Chen W, Wang N, Barton K, Park KH, Aung T, Weinreb RN, Lam DSC, Fan S*, Tham CC*, Zhang X*. Efficacy and safety of surgical peripheral iridectomy, goniosynechialysis, and goniotomy for advanced primary angle-closure glaucoma without cataract: one-year results of a multicenter study. J Glaucoma. 2024 Sep 1;33(9):632-639. 
17. Lin F#, Lu P#, Song Y, Gao X, Zhang Y, Nie X, Peng Y, Li X, Zhu X, Zhang H, Zhang Y, Xie L, Tang G, Tang L, Fan S*, Zhang X*. Surgical outcome and safety of peripheral iridectomy plus goniosynechialysis and goniotomy in the treatment of advanced primary angle-closure glaucoma. Chin J Exp Ophthalmol. 2023 Feb;41(2):134-139.
18. Friedman DS#*, Gazzard G, Foster PJ. Is phacogoniotomy the best surgery for PACG and cataract? JAMA Ophthalmol. 2025 Jun;143(6):470-1. 
19. Chan PP#*, Tham CC*, Lam DSC*. Re-establishment of the physiological pathway of aqueous humor drainage in primary angle-closure glaucoma: phacoemulsification, goniosynechialysis, and goniotomy. Asia Pac J Ophthalmol (Phila). 2022 Nov;11(6):497-9.
20. Friedman DS#*, Aung T, He M, Foster PJ. Two Decades of Angle-Closure Glaucoma Research. Ophthalmol Glaucoma. 2025 Sep-Oct;8(5S):S45-S48.
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22. Chan PP#, Zhang X#, Aung T, Chew PTK, Congdon N, Dada T, Fang SK, He M, Kim CY, Lai JSM, Lee JWY, Liang Y, Lingam V, Liu CY, Rojanapongpun P, Sun X, Tang X, Tham CCY*. Controversies, consensuses, and guidelines for acute primary angle closure attack (APACA) by the Asia-Pacific Glaucoma Society (APGS) and the Academy of Asia-Pacific Professors of Ophthalmology (AAPPO). Asia Pac J Ophthalmol (Phila). 2025 Nov-Dec;14(6):100223.
23. Zhang X#, Lin F, Li F, Lee JWY, Tham CC*. Minimally Invasive Glaucoma Surgery: A New Era in Glaucoma Treatment. Asia Pac J Ophthalmol (Phila) 2023;12:509-511.
24. Chan PPM#, Larson MD, Dickerson JE Jr, Mercieca K, Koh VTC, Lim R, Leung EHY, Samuelson TW, Larsen CL, Harvey A, Töteberg-Harms M, Meier-Gibbons F, Shu-Wen Chan N, Sy JB, Mansouri K, Zhang X, Lam DSC*. Minimally Invasive Glaucoma Surgery: Latest Developments and Future Challenges. Asia Pac J Ophthalmol (Phila) 2023;12:537-564.

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