Managing the ocular surface after glaucoma filtration surgery: an orphan topic.

Autor: Agnifili L; Ophthalmology Clinic, Department of Medicine and Aging Sciences, University 'G. D'Annunzio' of Chieti-Pescara, Chieti, Italy. l.agnifili@unich.it., Figus M; Ophthalmology Unit, Department of Surgery, Medicine, Molecular and Emergency, University of Pisa, Pisa, Italy., Sacchi M; University Eye Clinic, San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy., Oddone F; IRCCS-Fondazione Bietti, 00198, Rome, Italy., Villani E; University Eye Clinic, San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy., Ferrari G; IRCCS San Raffaele Scientific Institute, Division of Neuroscience, Cornea and Ocular Surface Disease Unit, Eye Repair Lab, Milan, Italy.; Vita-Salute San Raffaele University, Department of Ophthalmology, Milan, Italy., Posarelli C; Ophthalmology Unit, Department of Surgery, Medicine, Molecular and Emergency, University of Pisa, Pisa, Italy., Carnevale C; IRCCS-Fondazione Bietti, 00198, Rome, Italy., Nucci P; University Eye Clinic, San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy.; Department of Clinical Science and Community Health, University of Milan, Milan, Italy., Nubile M; Ophthalmology Clinic, Department of Medicine and Aging Sciences, University 'G. D'Annunzio' of Chieti-Pescara, Chieti, Italy., Mastropasqua L; Ophthalmology Clinic, Department of Medicine and Aging Sciences, University 'G. D'Annunzio' of Chieti-Pescara, Chieti, Italy.
Jazyk: angličtina
Zdroj: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie [Graefes Arch Clin Exp Ophthalmol] 2024 Jul; Vol. 262 (7), pp. 2039-2056. Date of Electronic Publication: 2023 Dec 13.
DOI: 10.1007/s00417-023-06333-5
Abstrakt: Background: Ocular surface (OS) disorders before glaucoma filtration surgery (GFS) have been considered to play a crucial role influencing the surgical outcome. Conversely, the impact of surgery itself on the OS is almost completely overlooked, though evidence suggest that ocular surface disease (OSD) may be induced in patients by GFS. This review analyzes the determinants involved in the OSD development after GFS, the clinical features and related consequences, the main diagnostic hallmarks, as well as the therapeutic strategies for its management.
Methods: The PubMed database was utilized for the literature examination. Keywords that were searched included ocular surface disease, glaucoma filtration surgery, filtration bleb, post-surgical management, and quality of life.
Results: After GFS, OSD is promoted by peri- and post-operative factors, such as the filtration bleb (FB) development, combined surgical approach with phacoemulsification, the use of antifibrotic agents and the reintroduction of antiglaucoma medications. This particular form of OSD that present similar clinical features to mild to moderate dry eye, can be named as post-glaucoma surgery-OSD (PGS-OSD). PGS-OSD may negatively affect the FB functionality, thus potentially hindering the disease control, and significantly worsen the patient quality of life (QOL).
Conclusions: Clinicians are encouraged to routinely include the OS evaluation after GFS and to consider proper management when the occurrence of PGS-OSD worsen the patient's QOL or exert negative effects to the FB functionality. An outline summarizing the main risk factors and the most appropriate therapeutic options to mitigate the PGS-OSD was proposed to support the routine practice.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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