Refractory Glaucomas. Types and Management

Abstract

Certain types of glaucomas do not respond to conventional trabeculectomy; they are named refractory glaucomas. They are notorious and often recurrent.  Examples include: childhood, neovascular, uveitic, traumatic, glaucomas with wide conjunctival scars, post-vitrectomy, post-keratoprosthesis, post-keratoplasty, ciliary block, recurrent and glaucoma in aphakic and pseudophakic eyes. Some of those glaucomas require specific medical management like uveitic glaucoma. However, surgical intervention is ultimately needed in most of cases. Different surgical strategies include: antimetabolites-assisted trabeculectomy, drainage implants, cyclodestructive surgeries and other approaches. This review article will discuss the current management strategies for refractory glaucomas and the application of those treatment modalities to the specific glaucoma types.