Objective: This study aims to conduct an analysis glaucoma surgeries performed over a 13-year period at a tertiary hospital affiliated with the Spanish National Health System, with the goal of assessing temporal trends. Methods: This retrospective observational study scrutinized surgeries undertaken in the glaucoma unit of a tertiary center in Spain between 2010 and 2022. Data collected included surgical dates, procedure performed, whether it was standalone or combined, as well as patient demographics including age, sex, and type of underlying glaucoma. Surgeries on individuals under 18 years of age were excluded. An annual comparative analysis was performed to ascertain the evolving trends in glaucoma surgical interventions. Results: A total of 12,944 surgeries were included in the analysis, comprising 9428 isolated cataract surgeries and 2975 glaucoma procedures. Trabeculectomy, glaucoma drainage devices (GDD), and cyclodestruction, collectively referred to as traditional surgery, demonstrated a decline from 93.2% to 23.6% over the study duration. Minimally invasive glaucoma surgery (MIGS) and minimally invasive bleb surgery (MIBS) demonstrated a significant increase from 3.8% in 2010 to 74.7% in 2022, relative to the total glaucoma surgeries. Furthermore, combined surgeries manifested a noteworthy increase from 39.0% in 2010 to 44.2% in 2022, with 86.4% of combined procedures in 2022 being MIGS or MIBS. Conclusion: In recent years, there has been a noticeable change in the trend of glaucoma surgeries, with MIGS and MIBS procedures experiencing a significant increase and becoming the most commonly performed glaucoma procedures. Consequently, traditional glaucoma surgeries have decreased in frequency.

Background: Glaucoma is a neurodegenerative disease and the second leading cause of irreversible blindness in developed countries. It is characterized by progressive loss of retinal ganglion cells (RGCs) and optic nerve axons, leading to permanent vision impairment. Although elevated intraocular pressure (IOP) is the main recognized risk factor, recent evidence suggests that ocular and gut microbiota may play a significant role in the onset and progression of glaucoma. Objectives: This study aimed to characterize ocular and gut microbiota alterations in patients with different types of glaucoma. Methods: Five searches were conducted between June and September 2025 using selected keywords. A total of 121 articles were identified, of which 14 met the inclusion criteria following the PRISMA 2020 guidelines. Results: Findings indicate a Mendelian genetic predisposition influencing microbiota composition associated with glaucoma development. Patients treated with benzalkonium chloride (BAK) showed increased Gram-negative and Alphaproteobacteria on the ocular surface, along with enhanced lipopolysaccharide synthesis. Compared with controls, glaucoma patients exhibited reduced Corynebacterium mastiditis and Actinobacteria and increased Firmicutes, Proteobacteria, and Verrucomicrobiota. Dysbiosis was more pronounced in patients with concurrent dry eye disease, characterized by higher Gram-negative taxa and pro-inflammatory microbial activity. Conclusions: Significant differences in ocular and gut microbiota were observed between glaucoma patients and controls, as well as among glaucoma subtypes such as pseudoexfoliation and primary open-angle glaucoma. Age-related dysbiosis and epigenetic factors appear to contribute to disease development. Microbiota profiling may offer new opportunities for improved prediction, management, and treatment of glaucoma.

Preserflo MicroShunt (PMS) has emerged as a safe and effective subconjunctival implant for lowering intraocular pressure in glaucoma. Although most postoperative complications occur early and are transient, long-term data remain limited—particularly regarding rare but serious events such as device exposure or extrusion, which may threaten ocular integrity. This report presents 3 clinical cases of PMS exposure with distinct presentations, potential risk factors, and surgical management approaches. In the first case, a pseudophakic patient with primary open angle glaucoma developed exposure of the device body 8 months postoperatively, associated with conjunctival ischemia but without leakage. In the second case, exposure of a nonfunctioning PMS occurred 2 years after a second implant was placed in a different quadrant, following early failure of the original device. The exposed implant was removed without compromising IOP control. The third and most severe case involved extensive scleral melting, distal extrusion, and Seidel positivity, requiring device explantation and scleral grafting. Contributing factors included the use of 0.04% mitomycin C, previous surgeries, and intraoperative identification of thin Tenon’s capsule. Based on these cases, PMS exposure may arise through different mechanisms—distal extrusion, body erosion, or conjunctival dehiscence—each necessitating tailored surgical intervention. Awareness of risk factors and prompt management are essential to prevent complications such as infection or hypotony. These findings highlight the importance of careful intraoperative assessment, personalized MMC application, and early detection to ensure long-term safety and device preservation.