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Despite decades of research, intraocular pressure reduction remains the sole therapeutic intervention proven to slow glaucoma progression. Trabeculectomy and glaucoma drainage devices aim to reduce IOP by draining aqueous humor to the subconjunctival space. Two newer devices, the XEN Gel Stent (Allergan) and the InnFocus MicroShunt (InnFocus/Santen), also produce de novo subconjunctival outflow pathways.
The long-term success of any glaucoma filtration operation depends upon maintenance of aqueous humor flow to the subconjunctival space, which can be compromised by postoperative episcleral Tenon fascial fibrosis. Many factors increase the likelihood of excessive fibrosis following glaucoma surgery. It is vital for a surgeon to efficiently recognize these characteristics in order to maximize post-operative success.
This Focal Points module discusses risk factors that lead to scarring and surgical failure, reviews applications of antifibrotics in glaucoma surgery and evaluates the current roles of these medications. Investigational approaches to the modulation of wound healing in glaucoma surgery are also discussed.
By completing this module, you will be able to:
Authors: Thomas V. Johnson, MD, PhD; Angelo P. Tanna, MD
Focal Points issues review the most crucial advances and feature insights to help you integrate tested research into your practice.
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The American Academy of Ophthalmology is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The American Academy of Ophthalmology designates this enduring material for a maximum of 2 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.