Managing the ocular surface after glaucoma filtration surgery: an orphan topic

Area of Science:

• Ophthalmology
• Glaucoma Research
• Ocular Surface Disease

Background:

• Pre-existing ocular surface disorders influence glaucoma filtration surgery (GFS) outcomes.
• The impact of GFS on the ocular surface is often overlooked, despite evidence suggesting GFS can induce ocular surface disease (OSD).
• This review examines factors, clinical features, diagnosis, and management of OSD post-GFS.

Purpose of the Study:

• To analyze determinants of OSD development after GFS.
• To describe clinical features and consequences of post-GFS OSD.
• To outline diagnostic hallmarks and therapeutic strategies for managing OSD after GFS.

Main Methods:

• Literature review using PubMed database.
• Keywords included: ocular surface disease, glaucoma filtration surgery, filtration bleb, post-surgical management, quality of life.

Main Results:

• Post-GFS OSD is associated with filtration bleb development, combined phacoemulsification, antifibrotic agents, and glaucoma medications.
• This condition, termed post-glaucoma surgery-OSD (PGS-OSD), presents like mild to moderate dry eye.
• PGS-OSD can impair filtration bleb function, hinder glaucoma control, and reduce patient quality of life.

Conclusions:

• Routine ocular surface evaluation post-GFS is recommended.
• Management of PGS-OSD is advised when it affects quality of life or filtration bleb function.
• A guide to risk factors and therapeutic options for PGS-OSD is provided for clinical practice.