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Glaucoma Surgery: Current Challenges and Future Perspectives

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: 20 January 2026 | Viewed by 199

Special Issue Editors


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Guest Editor
Duke-NUS Medical School, Singapore, Singapore
Interests: glaucoma; MIGS; ophthalmic therapies; drug delivery

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Guest Editor
Department of Ophthalmology, Universitätsmedizin Mainz, Mainz, Germany
Interests: glaucoma; adult and childhood glaucoma; MIGS; epidemiology
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Special Issue Information

Dear Colleagues,

Glaucoma surgery faces several challenges that impact effectiveness and patient outcomes. The variability in surgical success rates is influenced by factors such as individual anatomy and pathophysiology. Post-operative scarring remains a very important obstacle for long-term surgical success of external filtration procedures.

Advances in biomaterials and targeted gene therapy seek to reduce scarring and improve performance of the surgical implants or trabeculectomy. Emerging imaging and AI may transform glaucoma management by enabling more personalized and predictable surgical outcomes. Advanced imaging techniques using optical coherence tomography provide detailed visualization of ocular structures, aiding precise surgical planning. It is anticipated that AI-driven models can identify patients at higher risk of complications and optimize timing and choice of surgery. Overall, integrating imaging and AI enhances accuracy, individualization, and prognosis in surgery, ultimately leading to better patient outcomes and more efficient, targeted treatments tailored to individual patients.

Future perspectives in glaucoma surgery aim to enhance safety, efficacy, and patient quality of life. This will include personalized surgical approaches based on genetic and biometric patient data, combined with advancements in imaging, biomaterials and regenerative medicine. Integrating technological innovations and personalized medicine may provide safer and more effective surgical options for glaucoma management in the future.

Prof. Dr. Tina Tzee Ling Wong
Prof. Dr. Esther M. Hoffmann
Guest Editors

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Keywords

  • glaucoma
  • filtration surgery
  • trabeculectomy
  • MIGS
  • scarring
  • anti-metabolites
  • wound healing
  • anti-fibrotics

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Published Papers (1 paper)

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Research

13 pages, 1755 KiB  
Article
Early Intrableb Features on Anterior Segment Swept-Source Optical Coherence Tomography Predict Surgical Success After Trabeculectomy in Uveitic and Neovascular Glaucoma
by Sangwoo Moon, Seungmin Lee and Jiwoong Lee
J. Clin. Med. 2025, 14(15), 5499; https://doi.org/10.3390/jcm14155499 - 5 Aug 2025
Viewed by 55
Abstract
Background: This study aimed to evaluate prognostic factors of early filtering blebs using anterior segment swept-source optical coherence tomography (AS SS-OCT) in patients with uveitic and neovascular glaucoma. Methods: This retrospective cohort study included 22 eyes from 22 patients who underwent [...] Read more.
Background: This study aimed to evaluate prognostic factors of early filtering blebs using anterior segment swept-source optical coherence tomography (AS SS-OCT) in patients with uveitic and neovascular glaucoma. Methods: This retrospective cohort study included 22 eyes from 22 patients who underwent trabeculectomy (11 eyes each with uveitic or neovascular glaucoma). Intrableb characteristics were assessed using AS SS-OCT at 1 month, postoperatively. Surgical success was defined as intraocular pressure (IOP) ≤ 18 mmHg and ≥30% IOP reduction without medication at 12 months. Logistic regression was used to identify the prognostic factors associated with IOP control. Results: Sixteen eyes (72.7%) achieved surgical success, while six (27.3%) were unsuccessful. Eyes with successful IOP control at 12 months showed thicker and less reflective bleb walls with microcysts compared with unsuccessful cases of IOP control, in the early postoperative phase (all p < 0.033). However, IOP at the time of OCT did not significantly differ between the groups (p = 0.083). Multivariate logistic regression analysis revealed that higher bleb wall reflectivity at 1-month post-trabeculectomy was significantly associated with a higher surgical failure rate at 12 months after trabeculectomy (hazard ratio = 1.072, p = 0.032). Conclusions: Early intrableb assessment using AS SS-OCT may be beneficial for managing filtering blebs after trabeculectomy in uveitic and neovascular glaucoma. Higher bleb wall reflectivity in the early post-trabeculectomy phase may indicate poor features of the filtering bleb, suggesting the need for timely interventions for refractory cases. Full article
(This article belongs to the Special Issue Glaucoma Surgery: Current Challenges and Future Perspectives)
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