{
  "abstract": "Purpose: To evaluate long-term outcomes and safety of non-cyclodialytic, bleb-independent surgical enhancement of uveoscleral outflow for intraocular pressure (IOP) reduction in open-angle glaucoma (OAG), and to assess the role of conjunctival lymphatic vessels (CLVs) in suprachoroidal drainage. Methods: In this single-center consecutive case series, 70 eyes of 63 patients (mean age 75.0 years; 70% female) with moderate-to-severe OAG underwent uveoscleral outflow enhancement. Twenty-two eyes had standalone surgery; 48 eyes had combined phacoemulsification with glaucoma surgery. Mean follow-up was 24.1 months (range 5.3-60.4). Primary outcomes were IOP reduction and surgical success by Kaplan-Meier analysis (sustained failure: IOP > 18 mmHg or < 20% reduction from baseline at two consecutive available postoperative visits, excluding day 1). CLVs were assessed by slit-lamp and OCT at 11 time points over 36 months. Mixed-effects models with random intercept per eye were used for repeated measurements. Logistic regression with cluster-robust standard errors evaluated predictors of CLV visibility. Results: Baseline IOP of 28.8 ± 8.4 mmHg decreased to 12.3 ± 4.5 mmHg at 1 month (54.5% reduction) and 14.5 ± 2.5 mmHg at 36 months (46.2% reduction, n = 22). Medications decreased from 2.77 ± 0.94 to 1.36 ± 1.09 at 36 months. Overall surgical survival was 91.4% at 1 month, 82.0% at 12 months, and 74.1% at 36 months. Fifteen eyes (21.4%) met sustained failure criteria (standalone surgery group: eight, combined surgery group: seven; and log-rank p = 0.038). The combined surgery group showed higher survival at 36 months (82.6% vs. 58.5%), but the difference did not reach significance. CLVs were detected in 51.4% by slit-lamp and 96.4% by OCT, peaking at 1 month. Before surgery, CLVs were not detected on OCT in any eye. Time was a significant negative predictor of CLV visibility on both slit-lamp (OR 0.953/month, p = 0.046) and OCT (OR 0.935/month, p = 0.003), without independent association with IOP or medication burden, suggesting that CLVs facilitate suprachoroidal drainage as a structural mechanism rather than a reactive response to IOP changes. Conclusions: Non-cyclodialytic, bleb-independent uveoscleral outflow enhancement provides sustained IOP reduction with favorable safety. CLVs, nearly universally detected by OCT after surgery, appear to contribute to suprachoroidal drainage. Combined surgery showed a trend toward greater surgical success than standalone procedures.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Eye Diseases, Medical Institute, Patrice Lumumba Peoples' Friendship University of Russia, 6 Mikluho-Maklaya St., 117198 Moscow, Russia.",
    "Centre of Eye Microsurgery \"PRO Zrenie\", 1 Gorshina Str., 141407 Khimki, Russia.",
    "Independent Researcher, 2297 street, building 18, Sultangazi Area, 34265 Istanbul, Türkiye."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Vinod Kumar",
      "orcid": "0000-0002-5489-4607"
    },
    {
      "affs": [
        0
      ],
      "name": "Mikhail Aleksandrovich Frolov"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Galina Nikolaevna Dushina"
    },
    {
      "affs": [
        1
      ],
      "name": "Andrey Igorevich Bezzabotnov",
      "orcid": "0000-0002-5677-3649"
    },
    {
      "affs": [
        1
      ],
      "name": "Ahmad Saleh Soliman Shradqa"
    },
    {
      "affs": [
        2
      ],
      "name": "Zarina Shaykuliyevna Rustamova"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/fgcdpkk779w72.bib",
  "cited_by": 0,
  "doi": "10.3390/vision10040084",
  "fulltext_url": "https://europepmc.org/articles/PMC13709785",
  "id": "fgcdpkk779w72",
  "issns": [
    "2411-5150"
  ],
  "landing_url": "https://europepmc.org/article/MED/42931622",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2731|Glaucoma and retinal disorders"
    ]
  ],
  "openalex": "W7221987025",
  "pdf_url": "https://europepmc.org/articles/PMC13709785?pdf=render",
  "pmcid": "PMC13709785",
  "pmid": "42931622",
  "published": "2026-10-15",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/fgcdpkk779w72.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:22:01Z",
      "native_id": "MED:42931622",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42931622"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2731|Glaucoma and retinal disorders",
      "subfield": "general"
    }
  ],
  "title": "Long-Term Outcomes and Safety of Non-Cyclodialytic, Bleb-Independent Surgical Enhancement of Uveoscleral Outflow in Open-Angle Glaucoma, with Evaluation of the Role of Conjunctival Lymphatic Vessels in Suprachoroidal Drainage.",
  "title_text": "Long-Term Outcomes and Safety of Non-Cyclodialytic, Bleb-Independent Surgical Enhancement of Uveoscleral Outflow in Open-Angle Glaucoma, with Evaluation of the Role of Conjunctival Lymphatic Vessels in Suprachoroidal Drainage.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:22:01Z",
  "url": "https://research.draconitic.com/paper/fgcdpkk779w72",
  "venue": "Vision (Basel, Switzerland)",
  "versions": []
}