The results of comparative studies of the structural and biomechanical features of the corneoscleral eye shell in various clinical forms of glaucoma are presented. The article discusses how the systemic and local imbalance of trace elements that regulate collagen biosynthesis, the formation of cross-links in the connective tissue structures of the sclera, and the hydrodynamics of the intraocular fluid, affect the intraocular pressure level, and thereby the character of the development of glaucomatous lesions in normal tension glaucoma. Modern literature is shown to indicate the prospects for further research in this direction.

Glaucoma is a socially sensitive disease, being one of the leading causes of irreversible visual impairment and blindness. Refractory glaucoma is one of the most severe forms of the disease as it is resistant to conservative and surgical methods of treatment. Because of pronounced postoperative fibroblastic activity of eye tissues, leading to gross scarring and obliteration of outflow paths, modern materials and methods of drainage surgery are needed. The review presents a variety of drains used today and considers in detail their main characteristics and the biocompatibility of the material used with eye tissues. Various groups of implants are presented, whose effectiveness and safety are compared and assessed. The statistics of postoperative complications and long-term results of surgical treatment are given.