Our Summary

Glaucoma is a disease that damages the optic nerve in the eye, and it’s the top cause of irreversible blindness around the world. There’s currently no cure for it. The only proven way to treat it is by lowering the pressure within the eye, which can be done through a surgery known as glaucoma filtration surgery (GFS). However, about 10% of these surgeries fail each year because the healing process can cause excessive scarring or fibrosis.

To develop and test new treatments, researchers often use animal models. This review paper looked at the various types of animal models and drugs that are currently being studied. They found that small rodents like mice and rats are typically used to study the scarring process after surgery and to test new drugs. Rabbits, with their larger eyes, are better for developing medical devices.

New drugs are being studied that aim to block specific pathways involved in the scarring process. These include modulators, monoclonal antibodies, aqueous suppressants, and gene therapy. Although these new drugs appear to be safer than existing treatments, they are often not as effective.

The authors of this review suggest that future research should focus on improving the animal models used for research, and on standardizing the research methods used across different research groups. They also suggest that more research is needed to optimize new treatments, such as studying different dosages, methods of administration, frequency of use, combination therapies, and ways to deliver the drugs over a sustained period.

FAQs

  1. What is glaucoma filtration surgery (GFS) and how does it help in treating glaucoma?
  2. What are the new treatments being studied for glaucoma?
  3. Why do some glaucoma filtration surgeries fail and how are researchers trying to improve these outcomes?

Doctor’s Tip

One helpful tip a doctor might give a patient about glaucoma surgery is to follow post-operative care instructions carefully. This may include using prescribed eye drops, avoiding strenuous activities, and attending follow-up appointments. It is important to monitor your eye pressure regularly and report any changes or concerns to your doctor immediately. By following these instructions, you can help ensure the success of your glaucoma surgery and maintain the health of your eyes.

Suitable For

Patients who are typically recommended for glaucoma surgery are those who have not responded well to other treatments such as eye drops, laser therapy, or oral medications. They may have severe or rapidly progressing glaucoma, high eye pressure that cannot be controlled with medication, or significant damage to the optic nerve. Patients who are at risk of losing their vision despite treatment may also be recommended for surgery. Additionally, patients who have complications from their current glaucoma medications or who have difficulty with compliance may also be good candidates for surgery. Ultimately, the decision to undergo glaucoma surgery should be made in consultation with an ophthalmologist who can assess the individual patient’s situation and determine the best course of action.

Timeline

Before glaucoma surgery:

  • Patient is diagnosed with glaucoma through a comprehensive eye exam
  • Patient undergoes various treatments to lower intraocular pressure, such as eye drops, oral medications, or laser therapy
  • If these treatments are ineffective, patient may be recommended for glaucoma surgery

After glaucoma surgery:

  • Patient undergoes glaucoma filtration surgery to lower intraocular pressure and prevent further damage to the optic nerve
  • Patient experiences post-operative care, including follow-up appointments with their ophthalmologist, medications, and eye care instructions
  • Patient may experience temporary side effects such as blurred vision, eye discomfort, and sensitivity to light
  • Over time, patient’s vision stabilizes and they may experience improved vision and quality of life

It is important for patients to follow their ophthalmologist’s instructions for post-operative care to ensure successful outcomes and prevent complications. Regular follow-up appointments are also necessary to monitor the progression of the disease and adjust treatment as needed.

What to Ask Your Doctor

Some questions a patient should ask their doctor about glaucoma surgery include:

  1. What type of glaucoma surgery do you recommend for my specific condition?
  2. What are the potential risks and benefits of the surgery?
  3. What is the success rate of the surgery in terms of lowering eye pressure and preserving vision?
  4. What is the recovery process like after the surgery?
  5. Are there any alternative treatments or therapies that I should consider before opting for surgery?
  6. How often will I need follow-up appointments after the surgery?
  7. Are there any specific lifestyle changes or medications I should consider post-surgery?
  8. What should I do if I experience any complications or side effects after the surgery?
  9. Are there any specific precautions I should take to prevent further damage to my eye?
  10. Are there any ongoing clinical trials or new treatments that I should be aware of in case the surgery is not successful?

Reference

Authors: van Mechelen RJS, Wolters JE, Bertens CJF, Webers CAB, van den Biggelaar FJHM, Gorgels TGMF, Beckers HJM. Journal: Exp Eye Res. 2022 Apr;217:108972. doi: 10.1016/j.exer.2022.108972. Epub 2022 Jan 31. PMID: 35114212