Surgical Options for Glaucoma Patients with Failed Glaucoma Drainage Devices: A Systematic Review

Abstract

Glaucoma is the leading cause of irreversible blindness worldwide, with an expected continuous increase in prevalence. Intraocular pressure is the main modifiable risk factor. Despite the multiple treatment options, including medical or surgical, some patients require a glaucoma drainage device (GDD) to control the progression of the disease. However, this may lead to implant failure and the necessity of a further intervention. This systematic review aims to present surgical options available for patients with a failed GDD, guiding clinicians on how to better approach these situations and understanding the best intervention for each patient. We highlight second GDDs and laser procedures as possible effective solutions, but the heterogeneous and diverse definitions, criteria and reporting methodology demonstrate the necessity for more prospective and uniformly regulated studies.