glaucomaНациональный журнал ГлаукомаNational Journal glaucoma2078-41042311-6862Federal State Budgetary Institution of Science “Krasnov Research Institute of Eye Diseases”10.53432/2078-4104-2025-24-4-59-69glaucoma-597Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSВоспаление и фильтрующая хирургия глаукомы. Часть 1: факторы риска неудачи операцииInflammation and glaucoma filtration surgery. Part 1: risk factors for surgical failurehttps://orcid.org/0009-0009-8238-4741Абудайяк БахааА. М.Abudayyak BahaaA. M.

врач-офтальмолог, аспирант кафедры оториноларингологии  и офтальмологии

199034, Санкт-Петербург, Университетская наб., 7/9

ophthalmologist, postgraduate student at the Department  of Otorhinolaryngology and Ophthalmology

7/9 Universitetskaya Emb., Saint Petersburg, 199034

baha.jin@yandex.ruhttps://orcid.org/0000-0002-6393-1289НиколаенкоВ. П.NikolaenkoV. P.

д.м.н., профессор кафедры оториноларингологии и офтальмологии,  заместитель главного врача по офтальмологии

199034, Санкт-Петербург, Университетская наб., 7/9

194354, Санкт-Петербург, Учебный пер., 5

Dr. Sci. (Med.), Professor at the Department of Otorhinolaryngology and Ophthalmology, Deputy Chief Doctor for Ophthalmology

7/9 Universitetskaya Emb., Saint Petersburg, 199034

5 Uchebnyy Ln., Saint Petersburg, 194354

dr.nikolaenko@mail.ruФГБОУ ВО СПбГУРоссияSaint Petersburg State UniversityRussian FederationФГБОУ ВО СПбГУ; СПб ГБУЗ «ГМПБ № 2»РоссияSaint Petersburg State University; City Multidisciplinary Hospital No. 2Russian Federation2025011220252445969Copyright © Абудайяк Бахаа А.М., Николаенко В.П., 20252025Абудайяк Бахаа А.М., Николаенко В.П.Abudayyak Bahaa A.M., Nikolaenko V.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.glaucomajournal.ru/jour/article/view/597

Внутриглазное давление (ВГД) является единственным модифицируемым фактором риска развития и прогрессирования глаукомной оптической нейропатии, что делает его снижение основной целью терапии глаукомы. Несмотря на инновации в медикаментозном и лазерном лечении, хирургия фильтрующего типа остается ключевым, а часто единственным методом контроля ВГД. Однако у пациентов с длительным анамнезом глаукомы наблюдается комплекс патологических изменений глазной поверхности с преобладанием воспалительного компонента, развивающихся вследствие многолетнего использования местных, особенно консервантных, гипотензивных препаратов. Эти изменения характеризуются активацией медиаторов воспаления и клеточной инфильтрацией покровных тканей глаза, что существенно влияет на процессы послеоперационной репарации и в конечном итоге определяет исход хирургического вмешательства. Глубокое понимание патофизиологических механизмов этих изменений создает основу для разработки эффективных профилактических и лечебных мер, направленных на улучшение долгосрочных результатов хирургии. Настоящий обзор представляет анализ современных данных о воздействии гипотензивной терапии на состояние глазной поверхности. Особое внимание уделено дифференцированной оценке влияния активных веществ и консервантов глазных капель, роли предшествующих офтальмохирургических вмешательств, а также провоспалительному эффекту выполненной фильтрующей операции.

Intraocular pressure (IOP) is the only modifiable risk factor for the development and progression of glaucomatous optic neuropathy, making its reduction the primary goal of glaucoma therapy. Despite advances in medical and laser treatment, filtering surgery remains a key (and often the only) method of IOP control. However, in patients with a long history of glaucoma, chronic exposure to topical hypotensive medications, particularly preservative-containing formulations, induces a spectrum of pathological ocular surface alterations characterized predominantly by inflammation. These pathological changes are characterized by the activation of inflammatory mediators and cellular infiltration of the ocular surface tissues, which significantly impairs postoperative wound healing and ultimately determines surgical outcomes. A comprehensive understanding of the pathophysiological mechanisms underlying these changes provides the foundation for developing targeted preventive and therapeutic strategies aimed at improving long-term surgical success. This review evaluates current evidence regarding the consequences of long-term hypotensive therapy on the ocular surface, with particular emphasis on differential assessment of the effects of active ingredients and preservatives in eye drops, the impact of previous ophthalmic surgeries, and the pro-inflammatory effects associated with recent glaucoma filtration surgery

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The authors declare that there are no conflicts of interest present.