Inflammation and glaucoma filtration surgery. Part 3: the potential of triamcinolone acetonide in glaucoma surgery

Patients with glaucoma exhibit elevated levels of prionflammatory cytokines and growth factors, as well as cellular infiltration of the ocular surface tissues, which is associated with long-term use of topical hypotensive medications, particularly those containing preservatives. An additional contributing factor is filtering surgery itself, which leads to an increase in proinflammatory cells and biologically active substances in the already altered conjunctiva. The resulting excessive and prolonged inflammatory response promotes the development of early subconjunctival fibrosis, causing obstruction of filtration pathways and subsequent elevation of intraocular pressure. Therefore, postoperative management after trabeculectomy requires careful control of inflammation. Despite low bioavailability and rapid elimination, which necessitate frequent and prolonged use in the postoperative period, topical anti-inflammatory agents remain the cornerstone for preventing these complications. These limitations highlight the need to search for more effective alternatives and to refine existing therapeutic strategies. This review presents current data on the pharmacokinetics, safety profile, and clinical use of triamcinolone acetonide in ophthalmology and analyzes its potential as a promising agent for improving long-term outcomes of filtering surgery due to its sustained anti-inflammatory action.