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Fibrosis-Associated Fluid Biomarkers for Predicting Surgical Outcomes in Glaucoma Surgery: A Systematic Review
Roderick E Gachette1,2, Christian J F Bertens3, Marlies Gijs1,2
1University Eye Clinic Maastricht, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands.
Current Eye Research
|April 6, 2026
Summary
Biomarkers in aqueous humor, tear fluid, and Tenon tissue are linked to glaucoma surgery failure due to fibrosis. Identifying these markers is key to improving surgical success rates.
Area of Science:
- Ophthalmology
- Biomarker Research
- Surgical Outcomes
Background:
- Glaucoma surgery is vital for advanced glaucoma.
- Fibrosis-induced bleb failure is a major complication.
- Understanding fibrosis is crucial for enhancing surgical outcomes.
Purpose of the Study:
- To systematically review biomarkers in aqueous humor, Tenon, and tear fluid.
- To assess associations between biomarkers, fibrosis, and glaucoma surgery outcomes.
Main Methods:
- Systematic search of Embase and MEDLINE databases.
- Inclusion of articles up to December 5th, 2025.
- Snowball method for additional study identification, totaling 20 articles.
Main Results:
- 353 biomarkers were studied in relation to failed glaucoma surgery.
- Specific biomarkers (MCP-1, TGF-β, VEGF, IFN-γ, MMP-3, SPARC, IL-1 to IL-18) in AH, TF, and TN showed significant associations.
- Failure linked to increased pro-inflammatory and decreased anti-inflammatory biomarkers, with high variability noted.
Conclusions:
- Further research and standardized protocols are necessary.
- Reliable biomarkers are essential for developing targeted therapies.
- Improving glaucoma surgery success requires better understanding and modulation of fibrosis.
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