A bibliometric analysis of the top 50 most-cited articles in glaucoma management

Background: As the foremost cause of irreversible vision loss around the world, glaucoma continues to be the leading factor behind irreversible blindness. Even with progress in diagnostic tools, surgical techniques, and additional therapies, the disease continues to be problematic because of its asymptomatic onset and the partial effectiveness of pressure-reducing treatments. The overall role of significant publications in guiding glaucoma research has not been thoroughly evaluated. Methods: A bibliometric study was carried out to determine the 50 articles on glaucoma with the highest citation counts, with searches conducted in the Web of Science database. Four reviewers independently screened the articles. The extracted information covered authorship, country of origin, journal name, study design, level of evidence, citation counts, and thematic focus. Citation and co-occurrence mapping were applied. Results: The 50 most-cited articles accrued 4054 citations (mean: 81.1), peaking in the 2000s (42%). The US (52%) and UK (30%) led contributions, primarily in Ophthalmology and British Journal of Ophthalmology. Level II evidence predominated (44%), followed by Level IV evidence (38%). Retrospective cohort studies comprised the most common study design (36%), followed by case series (30%), while randomized controlled trials represented 12% of the included studies. Key themes included diagnostic integration, trabeculectomy, minimally invasive surgery (MIGS), and refractory disease management. Conclusion: Most-cited glaucoma-management literature was characterized by retrospective study designs and representation of both traditional filtration surgery and emerging device-based approaches, including MIGS. These findings describe patterns of scholarly attention within highly cited glaucoma-management literature and should not be interpreted as trends across the entire field or as evidence of comparative clinical effectiveness.