Innovative Tube Trabeculectomy for Advanced and Refractory Glaucoma: a Randomized Controlled Trial

Glaucoma is a leading cause of irreversible blindness. While trabeculectomy is a standardsurgical intervention, its long‐term success can be compromised by fibrosis. The ITTtechnique introduces several innovations to address these limitations. Thissingle‐center, prospective, randomized controlled trial will enroll adult patients withadvanced or refractory open‐angle glaucoma. Patients will undergo a rigorous preoperativeregimen before being randomized to either the ITT group or the conventionaltrabeculectomy group. The primary outcome will be surgical success (IOP ≤ 15 mmHg and ≥20% reduction from baseline without medication) at 12 months. Secondary outcomes includemean IOP, medication burden, complication rates, bleb morphology (UBM/AS‐OCT), visualacuity, visual fields, and quality of life. The study will provide crucial evidence onthe potential benefits of ITT for this challenging patient population.