In the last 50 years, trabeculectomy with antimetabolites has been the gold standard of glaucoma surgical treatment, with valved or non-valved glaucoma drainage devices also in use.
Both techniques have significant complications and are burdensome for the patient, so the surgical approach to glaucoma is often delayed to advanced stages and after prolonged multi-drug topical therapy even in clearly progressing patients.
Consequently, in recent years, there has been growing interest in techniques that minimize the risks of trabeculectomy and tubes, allowing an earlier and safer surgical approach.