Review Article November 26, 2025 November 26, 2025

Use of topical steroids in the preoperative preparation for trabeculectomy: a systematic review

DOI: 10.37039/1982.8551.20250090

ABSTRACT

Background:

Trabeculectomy is a common surgical technique performed when clinical treatments are not enough to control glaucoma. Prolonged use of eye drops to control intraocular pressure (IOP) can lead to ocular surface disease, negatively affecting postoperative results.

Objective:

This article aimed to analyze the current literature on the effects of preoperative preparation for trabeculectomy with topical corticosteroids on surgical outcome and postoperative intervention.

Methods:

A systematic review that followed PRISMA guidelines was performed, and articles were searched at PubMed, Embase and Cochrane up to March 7, 2024. Clinical trials investigating the use of corticosteroid eye drops in the preoperative preparation of glaucoma patients undergoing trabeculectomy were included.

Results:

Initially, 93 articles were identified. After exclusion based on title, abstract and full-text readings, three studies met the inclusion criteria. These studies suggested that the use of fluorometholone before surgery can reduce post-operative interventions and the need for hypotensive eye drops. Surgical success varied among the studies, with one reporting better outcome in the intervention group compared to the control, while the others found no significant differences.

Discussion:

Preoperative preparation for trabeculectomy with low-potency corticosteroids improves ocular inflammation caused by the chronic use of hypotensive eye drops, which can reduce the need for interventions on the filtering bleb post-surgery. However, further studies are required to establish effective guidelines for managing ocular surface health prior to surgery.