Avoiding and managing complications of glaucoma drainage implants

The incentive for continued interest in aqueous devices in selected cases is mainly the result of the 5% incidence of late "blebitis" and endophthalmitis. The purpose of this review is to cover the most common complications that may arise and to offer strategies and techniques to avoid or rectify the complication.

Complications of aqueous drainage devices are categorized in three stages: intraoperative, early postoperative (<1 month), and late postoperative (>1 month). Intraoperative complications consist of anterior chamber entry, tube misdirection, and scleral perforation. Early postoperative complication includes hypotony and flat anterior chamber, choroidal effusions, and suprachoroidal hemorrhage. Late postoperative complication comprise tube migration, tube or plate extrusion, motility disturbance, and infection.

Most complications seen in glaucoma drainage implants are self-resolving and rarely threaten visual outcome.