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As the long\u2010term use of intraocular pressure\u2010lowering medications significantly affect the OS health, patients with an uncontrolled disease frequently undergo glaucoma surgery in less\u2010than\u2010ideal conditions. As we known, OS changes strongly affect the post\u2010operative bleb filtration capability. Therefore, improving the OS conditions before proceeding with FS is needed. Currently, given the rapid diffusion of new surgical procedures, this need is even more perceived. Nevertheless, despite surgeons retain the OS preparation of primary importance, and recognize the OS disease (OSD) as the only modifiable risk factor for filtration failure, there is no agreement on which strategies should be preferred to prepare patients. This is largely due to the lack of validated guidelines, which forces clinicians to adopt personal approaches based on evidence derived from low\u2010quality studies. In this review, we provided an overview of risk factors involved in the FS failure, with particular attention to those depending on OS changes, and how OSD negatively affects the aqueous humor resorption after surgery. Moreover, we reported the most exploited measures to mitigate the OSD before surgery, the possible reasons underlying the absence of shared approaches, and the upcoming area of intervention to preserve the OS health during glaucoma management. Finally, based on the current evidence, we proposed a pre\u2010operative outline reporting the main risk factors that should be considered before surgery, and the therapeutical options available to improve the OS.<\/jats:p>","DOI":"10.1111\/aos.15098","type":"journal-article","created":{"date-parts":[[2022,1,28]],"date-time":"2022-01-28T05:19:24Z","timestamp":1643347164000},"page":"740-751","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Preparing the ocular surface for glaucoma filtration surgery: an unmet clinical need"],"prefix":"10.1111","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1625-6305","authenticated-orcid":false,"given":"Luca","family":"Agnifili","sequence":"first","affiliation":[{"name":"Department of Medicine and Ageing Science, Ophthalmology Clinic University \u2018G. 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