To Instill, to Deliver, to Implant, to Incise, to Protect: Innovations in Glaucoma Management—A Pharmaceutical Perspective

Dear Colleagues,

Glaucoma, the leading cause of irreversible blindness worldwide, is a progressive optic neuropathy frequently associated with elevated intraocular pressure (IOP). While conventional IOP-lowering treatments have substantially improved patient outcomes, in a significant number of cases, disease progression due to non-IOP-dependent triggers and side effects of therapies remain major concerns.

In recent years, driven by advances in pharmaceutical biotechnology, research efforts are focusing on more targeted, effective, and less invasive therapeutic strategies, either to control the disease better and in a more comprehensive way or to limit the adverse effects of therapies.

Advances in medical therapy include the development of novel drug classes, particularly those targeting the trabecular meshwork, alongside innovative drug formulation strategies such as controlled-release systems. These systems, designed using advanced pharmaceutical biotechnology, enhance pharmacokinetic profiles by improving bioavailability and prolonging ocular residence time, while their pharmacodynamic properties ensure sustained target engagement. This leads to improved patient adherence and minimizes systemic side effects. On the other side, to limit the side effects of medications on the ocular surface and the negative outcomes they produce on the control of the disease and on the quality of life, new pharmacological strategies continue to be explored and proposed.

Concurrently, growing insights into the pathophysiology of glaucomatous neurodegeneration have opened avenues for IOP-independent treatment strategies focused on neuroprotection and neuroregeneration. These include biopharmaceuticals such as neurotrophic factors, antioxidants, microglia modulators, and emerging modalities enabled by pharmaceutical biotechnology, such as gene and cell therapies, which represent a frontier in targeted pharmacodynamic intervention.

Finally, alongside pharmacological advances, the introduction of bio-implantable devices has definitely opened the era of the minimally invasive filtration surgery also in patients with glaucoma. This represents a significant step forward in the possibility to control the disease because of the well-documented efficacy of mini-invasive surgeries, very close to that of standard procedures, and the improved safety profile over traditional filtration surgery. Moreover, thanks to pharmaceutical biotechnology, new anti-fibrotic agents are going to be studied to better contain the post-operative scarring, which still remains the main risk factor for surgical failure.

This joint Special Issue will highlight recent advances across all areas of glaucoma therapy, including the impact of novel therapeutic formulations, biotechnology-based products, and advanced delivery devices on treatment adherence and quality of life, with a particular interest in studies integrating pharmacokinetic and pharmacodynamic principles. We welcome the submission of original research articles and reviews covering any therapy-related aspect of glaucoma management.

Pharmaceutics invites submissions related to drug delivery systems and innovative formulations, while Biomedicines encourages contributions centered on biological aspects.

You may choose our Joint Special Issue in Pharmaceutics.

Dr. Luca Agnifili
Dr. Matteo Sacchi
Dr. Michele Figus
Guest Editors

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• glaucoma
• medical therapy
• drug formulation
• drug delivery systems
• pharmaceutical biotechnology
• implantable devices
• pharmacokinetics
• pharmacodynamics
• laser therapy
• minimally invasive glaucoma surgery
• neuroprotection
• gene therapy
• neuroregeneration