Management of Refractory Glaucoma, a New Surgical Paradigm: Review of the Literature

To review current therapeutic strategies and innovations in the management of refractory glaucoma, with a focus on recent advancements in implantable surgical devices.

A comprehensive literature search across PubMed, Embase, and Cochrane Library, included terms such as "refractory glaucoma," "posterior drainage implants," "cyclodestruction," and "minimally invasive glaucoma surgery." Articles discussing surgical and medical interventions, as well as device innovations, were included.

Therapeutic options include creating new sites for filtering surgery, posterior drainage implants, minimally invasive devices, cyclodestruction, or continuing medical management without surgery.

Therapeutic decisions regarding refractory glaucoma should be made on a thoughtful, individualized basis, carefully weighing the expected benefits against the potential risks for the patient. Recent innovations in implantable devices expand the range of surgical possibilities.