Advances in glaucoma surgery

Despite being introduced over 50 years ago, the current gold standard for glaucoma surgery is still trabeculectomy. However, significant complications can occur with the procedure and, consequently, recent developments in glaucoma surgery have focused on improving safety and reliability. These developments can be categorized into three main areas: advances in filtering surgery, angle surgery and uveoscleral shunts. Each of these approaches has advantages and disadvantages, which are discussed in this review. In general, angle surgery and uveoscleral shunts do not appear to offer as low an intraocular pressure as filtering surgery, but appear to have fewer serious complications than filtering surgery. However, clinical data for these newer approaches are still limited in many cases, and further research is required to determine the role of new surgical options in glaucoma management.