Postoperative Complications And Safety Profiles After Surgical Management Of Advanced Glaucoma: A 4-Year Retrospective Analysis

To evaluate postoperative complications and safety outcomes following different surgical approaches for advanced to end-stage glaucoma.

Single-center retrospective study conducted at a specialized ophthalmology center.

Patients with advanced to end-stage glaucoma who underwent surgical treatment between 2021 and 2025 were retrospectively analyzed. Surgical procedures included minimally invasive glaucoma surgery (MIGS) combined with prostaglandin therapy, trabeculectomy, or implantation of the Ahmed Glaucoma Valve. Primary outcomes included rates of postoperative complications, need for surgical revision or additional glaucoma procedures, and long-term intraocular pressure (IOP) control over 36–48 months of follow-up.

All surgical approaches achieved sustained IOP reduction over the follow-up period. MIGS-based procedures demonstrated the lowest complication rates, with minimal incidence of hypotony or postoperative interventions. Trabeculectomy and Ahmed valve implantation achieved greater IOP reduction and higher medication-free success but were associated with higher rates of postoperative complications, including transient hypotony, bleb-related issues, and device-related events. The need for additional surgical interventions occurred more frequently following filtration-based procedures.

While filtration surgery and tube implantation achieve greater IOP reduction in advanced glaucoma, MIGS-based strategies demonstrate a more favorable safety profile with fewer postoperative complications. Surgical selection should therefore balance pressure-lowering efficacy against procedural risk, particularly in patients with advanced disease.