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Peer-reviewedCC BY-NCOphthalmology and Therapy

Optimizing the Ocular Surface Before, During, and After Glaucoma Surgery: A Narrative Review

  • Antoine Labbé1
  • Andrew J. Tatham2
  • Ingeborg Stalmans3
  • Christophe Baudouin1
  1. 1Hôpital National de la Vision des 15-20, INSERM-DGOS CIC1423, IHU FOReSight
  2. 2Department of Ophthalmology, Princess Alexandra Eye Pavilion and University of Edinburgh
  3. 3Department of Ophthalmology, University Hospitals UZ Leuven
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Abstract

This narrative review synthesizes the published literature on ocular surface disease (OSD) and glaucoma filtration surgery to develop practical, evidence-informed clinical and surgical recommendations for optimizing ocular surface management before, during, and after surgery. The reviewed studies examine how OSD affects ocular inflammation and wound healing, how chronic preservative-containing topical therapy affects bleb survival, and how reducing cumulative preservative load benefits ocular surface health. In patients with glaucoma, chronic use of preservative-containing topical medications can aggravate OSD, with approximately 50% of patients receiving topical intraocular pressure-lowering therapy reporting symptoms of OSD. OSD-related inflammation and tissue changes may adversely affect wound healing and compromise the success of glaucoma filtration surgery. OSD in patients likely to require filtration surgery should be actively identified and treated throughout the preoperative, intraoperative, and postoperative stages. Practical steps include screening for OSD, reducing exposure to preservative-containing medications, optimizing the ocular surface preoperatively, and minimizing conjunctival inflammation perioperatively. These strategies can be readily adopted into clinical practice and may help optimize conditions for bleb survival, although direct evidence demonstrating improved bleb survival is limited.

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Cite

BibTeXRIS
BibTeX
@article{labbe2026optimizing,
  title = {{Optimizing the Ocular Surface Before, During, and After Glaucoma Surgery: A Narrative Review}},
  author = {Antoine Labbé and Andrew J. Tatham and Ingeborg Stalmans and Christophe Baudouin},
  journal = {Ophthalmology and Therapy},
  year = {2026},
  month = sep,
  doi = {10.1007/s40123-026-01493-z},
  url = {https://doi.org/10.1007/s40123-026-01493-z},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - Optimizing the Ocular Surface Before, During, and After Glaucoma Surgery: A Narrative Review
AU  - Antoine Labbé
AU  - Andrew J. Tatham
AU  - Ingeborg Stalmans
AU  - Christophe Baudouin
PY  - 2026
DA  - 2026/09/01
JO  - Ophthalmology and Therapy
DO  - 10.1007/s40123-026-01493-z
UR  - https://doi.org/10.1007/s40123-026-01493-z
AB  - This narrative review synthesizes the published literature on ocular surface disease (OSD) and glaucoma filtration surgery to develop practical, evidence-informed clinical and surgical recommendations for optimizing ocular surface management before, during, and after surgery. The reviewed studies examine how OSD affects ocular inflammation and wound healing, how chronic preservative-containing topical therapy affects bleb survival, and how reducing cumulative preservative load benefits ocular surface health. In patients with glaucoma, chronic use of preservative-containing topical medications can aggravate OSD, with approximately 50% of patients receiving topical intraocular pressure-lowering therapy reporting symptoms of OSD. OSD-related inflammation and tissue changes may adversely affect wound healing and compromise the success of glaucoma filtration surgery. OSD in patients likely to require filtration surgery should be actively identified and treated throughout the preoperative, intraoperative, and postoperative stages. Practical steps include screening for OSD, reducing exposure to preservative-containing medications, optimizing the ocular surface preoperatively, and minimizing conjunctival inflammation perioperatively. These strategies can be readily adopted into clinical practice and may help optimize conditions for bleb survival, although direct evidence demonstrating improved bleb survival is limited.
SN  - 2193-8245
SN  - 2193-6528
ER  -