Is There a Need for New Surgical Procedures for Glaucoma? Yes!

George L Spaeth*, Victor Cvintal , Ana Figueiredo
Glaucoma Service, Wills Eye Institute, 840 Walnut St, Philadelphia, PA 19107, USA

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© Spaeth et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Glaucoma Service, Wills Eye Institute, 840 Walnut St, Philadelphia, PA 19107, USA; Tel/Fax: 215-928-3123; E-mail:


The only method to slow or stop progressive damage caused by glaucoma, the leading cause of irreversible blindness, definitively shown to be effective, is lowering intraocular pressure, though there is also evidence that stabilizing the pressure may be beneficial. Performing surgery on the eye has proven effective in some cases, using various techniques, though with variable frequencies of success (stabilization of the disease) and various frequencies and severities of complications. Surgery offers the great advantage of longer duration of action than medicinal treatments presently available, and, also, of lessening the need of the patient to be faithful using suggested medications. There is a need to develop surgical procedures which will be effective in 1) lowering or stabilizing intraocular pressure in a way most likely to prevent glaucomatous deterioration, 2) causing the fewest and least severe problems, and 3) being the most economical. Recent efforts in this regard are promising, but not yet proven superior to well-performed trabeculectomy, itself an evolving procedure.

Keywords: Complications, Cost/benefit ratio, cost effectiveness, effectiveness, glaucoma, guarded filtration procedure, minimally invasive glaucoma surgery, surgery, trabeculectomy.