Excessive scarring in glaucoma surgery. Part 1: Current concepts of wound healing in glaucoma surgery

The main complication of glaucoma surgery is cicatricial changes in newly formed outflow tracts. This process leads to a repeated increase in intraocular pressure (IOP) and is the reason for a decrease in the effectiveness of glaucoma surgeries. In the cascade of successive stages of surgical wound healing, the inflammation phase is considered the most important. Reducing its severity and duration is the main goal of postoperative therapy, since excessive inflammation leads to the formation of scar tissues. In turn, its excessive suppression leads to the development of "ineffective resolution". In this case, the inflammation becomes chronic, and the next healing phase does not occur. For complete restoration of the damaged tissue architecture, the healing process must consistently go through all phases. The use of pro-resolving mediators can contribute to the correct completion of inflammation. This review explores the physiological processes of restoration of the damaged tissue architecture, as well as the causes of cicatricial changes in the newly formed intraocular fluid outflow tracts.