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This abstract is assigned to session AOB Free Papers 1

Presentation type	Oral presentation
Title	Minimally Invasive Bleb Surgery (MIBS) in Patients at High Risk of Trabeculectomy Failure: A Scoping Review

Purpose	Trabeculectomy remains the reference filtration procedure, but fails more often in eyes with previous ocular surgery, secondary glaucoma, black race, long-term topical antiglaucoma therapy or young age. This scoping review maps the evidence on minimally invasive bleb surgery (MIBS) in patients with open-angle glaucoma carrying at least one of these recognised predictors of trabeculectomy failure.
Methods	Conducted in accordance with PRISMA-ScR guidelines. MEDLINE (via PubMed), Embase and Web of Science were searched for human studies in English, with no date restriction. The primary outcome was intraocular pressure (IOP); secondary outcomes were IOP-lowering medication use, treatment success, additional interventions and hypotony.
Results	Thirty-six studies (2017-2026, up to 1,379 eyes) were included: 30 retrospective, 6 prospective, no randomised trials. Median cohort: 24.5 eyes (range 5-153). Median IOP fell from 25.1 to 13.7 mmHg (median relative reduction 42.2%), and median medication count from 3.5 to 0.7 (median reduction 79.0%). Median reported rates: needling 33.8% (28 studies), bleb revision 19.8% (22 studies), reoperation 13.0% (28 studies), hypotony 15.6% (reported by only half the studies). Success definitions varied widely across studies.
Conclusion	In eyes at high risk of trabeculectomy failure, MIBS was consistently followed by lower IOP and medication burden, alongside a substantial reintervention burden. Comparison with trabeculectomy or glaucoma drainage devices remains unmade; prospective comparative studies are needed.
Conflict of interest	No
Details of conflicting interests	None relevant

Authors 1

Last name	DEMEESTERE
Initials	D
Department	UZ/KU Leuven
City	Leuven

Authors 2

Last name	Jacobs
Initials	T
Department	UZ/KU Leuven; CERA
City	Leuven; Melbourne

Authors 3

Last name	Martin
Initials	KR
Department	CERA
City	Melbourne

Authors 4

Last name	Kerr
Initials	NM
Department	CERA
City	Melbourne

Authors 5

Last name	Van Eijgen
Initials	J
Department	UZ/KU Leuven
City	Leuven

Authors 6

Last name	Stalmans
Initials	I
Department	UZ/KU Leuven
City	Leuven