Evidence architecture of glaucoma-related biomaterials reveals an uneven transition toward smart materials, additive...

Glaucoma-related biomaterial research has expanded from ocular drug delivery to responsive hydrogels, anti-fibrotic systems, glaucoma drainage device (GDD) and minimally invasive glaucoma surgery (MIGS)-related interfaces, retinal ganglion cell protection, trabecular meshwork models, and additive manufacturing. Whether this expansion represents a coherent transition toward smart, manufacturable, and function-oriented tissue-engineering systems remains unclear.

We conducted an AI-assisted, rule-guided, and manually audited evidence architecture reconstruction of glaucoma-related biomaterial studies published from 2006 to 2025. Records from Web of Science Core Collection, Scopus, and PubMed were integrated, deduplicated, parsed from RIS files, screened, and quality controlled. Retained studies were classified by application scenario, evidence level, and translational features. Core evidence records were assigned to five operational levels, from material preparation and physicochemical characterization to disease-microenvironment intervention, long-term functional integration, and clinical or advanced translational evidence. Theme maturity and the convergence of smart material, additive manufacturing, and tissue-engineering relevance were further assessed.

From 1,227 parsed records, 596 were retained, including 547 core evidence studies and 49 review or background records. In the core evidence set, Level 1 to Level 5 evidence included 93, 57, 140, 99, and 158 records, respectively. Level 1-3 evidence accounted for 53.0% of the core evidence set, whereas Level 4-5 evidence accounted for 47.0%, indicating a substantial but unevenly distributed translational component. In situ hydrogels and contact lens-based delivery systems represented the largest application categories, whereas retinal ganglion cell protection, trabecular meshwork modeling, anti-fibrosis after glaucoma surgery, GDD/MIGS-related interfaces, and 3D printing represented smaller but more disease-specific or integration-oriented domains.

Glaucoma-related biomaterials are moving beyond passive delivery platforms, but their transition toward smart materials, additive manufacturing, and functional tissue engineering remains uneven. Future studies should emphasize reproducible material design, disease-relevant functional endpoints, outflow-pathway models, neuroprotection, and engineered surgical interfaces.