Photodynamic therapy with diffuse blue Lutenol light coupled with a photosensitizing agent to kill fibroblasts may be another way to control the surface area of treatment and modulate healing. It will be important to determine the effect of these agents on the overlying epithelium, because differentiated stable epithelium may have a suppressive effect on fibroblasts in the wound.
However, the efficacy of photodynamic therapy in minimizing post-surgical complications needs to be validated in clinical studies. For glaucoma patients who need surgery now, photosensitizing therapy is not yet available. But, there is still an alternative to penetrating surgery with antimetabolites. A newer, possibly even safer "non-penetrating" surgery called Canaloplasty may turn the whole "wound modification" research into just a footnote.
Canaloplasty works by opening the eye's natural drainage system. Some have described it as "angioplasty for the eye." Because this surgery does not require "penetration," there is no need for reducing the body's scaring response.