Emerging Strategies in Glaucoma Treatment: MIGS, Cataract Surgery, and Novel Tube Placement Innovations

Glaucoma remains a leading cause of irreversible blindness worldwide. It affects millions and poses a significant challenge to public health. Recent evidence highlights the effectiveness of early surgical interventions, particularly cataract extraction combined with microinvasive glaucoma surgery (MIGS), in significantly reducing intraocular pressure (IOP) and the medication burden in patients over 50 years of age. Studies have shown that cataract surgery alone lowers IOP by 5–8.5 mmHg, while MIGS further enhances outcomes and delays disease progression. However, more severe cases of glaucoma often require the use of tube shunts, as traditional approaches like trabeculectomy carry substantial risks, such as fibrosis and hypertensive phases. Emerging techniques, such as retrobulbar or intraconal tube placement, are gaining attention for their potential to reduce complications and improve IOP control. Despite these advances, access to affordable MIGS remains inconsistent, highlighting a gap in equitable healthcare provision.

This Research Topic aims to explore the breadth of surgical options for glaucoma management, with a special focus on advancing early interventions and addressing disparities in healthcare access. One of the primary goals is to evaluate the role of cataract surgery and MIGS as first-line therapies for mild-to-moderate glaucoma, emphasising their impact on IOP reduction, medication dependence, and vision retention. Another key objective is to develop innovative, affordable surgical techniques suitable for underserved regions. In advanced glaucoma cases, the efficacy of novel interventions, such as retrobulbar and intraconal tubes, will be assessed. By addressing these various aspects, this topic seeks to propose actionable strategies that enhance surgical care distribution, particularly benefiting high-risk demographics such as Black and Afro-Latino patients.

To gather further insights in the pursuit of pioneering surgical strategies for glaucoma, we welcome articles addressing, but not limited to, the following themes:

- Early intervention through cataract surgery and MIGS as first-line therapies for primary open-angle glaucoma (POAG) and angle-closure glaucoma (ACG).
- Cost-effective MIGS adaptations, including manual techniques, Sinskey hook goniotomy, and improving device accessibility.
- Advanced management of glaucoma using retrobulbar/intraconal tube shunts and modifications of Ahmed valves, including strategies to mitigate complications.
- Socioeconomic influences on treatment access, focusing on insurance barriers, global accessibility, and equitable care models.

Article types and fees

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Classification
• Clinical Trial
• Data Report
• Editorial
• FAIR² Data
• FAIR² DATA Direct Submission
• General Commentary
• ... View all formats

Articles that are accepted for publication by our external editors following rigorous peer review incur a publishing fee charged to Authors, institutions, or funders.

Article types

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Classification
• Clinical Trial
• Data Report
• Editorial
• FAIR² Data
• FAIR² DATA Direct Submission
• General Commentary
• Hypothesis and Theory
• Methods
• Mini Review
• Opinion
• Original Research
• Perspective
• Review
• Study Protocol
• Systematic Review
• Technology and Code

Keywords: glaucoma, MIGS, early cataract surgery, retrobulbar, intraconal, tube shunt

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.