Glaucoma tube shunts: 2026 Update

To provide an update on new glaucoma drainage devices and implants.

Glaucoma drainage implant devices are currently indicated for medically or surgically uncontrolled glaucoma, especially in eyes at high risk for trabeculectomy failure. The devices used can differ, but many offer similar long-term outcomes. Due to the differences in devices, some of the side effect profiles may differ.

Long-term outcomes show that nonvalved devices (Ahmed ClearPath, Baerveldt, Molteno, Paul Glaucoma Implant) achieve greater intraocular pressure reduction and lower medication burden than valved devices (Ahmed valved implant) but come with a higher risk of hypotony-related complications; all devices have similar overall complication rates and comparable surgical failure rates at 2-5  years. The most recent updates as of 2025 highlight that Ahmed ClearPath ST and Paul Glaucoma Implant (only available internationally) offer streamlined implantation and favorable safety profiles, and Molteno and Baerveldt continue to provide durable IOP control in refractory cases. Two more devices, Calibreye (Myra Vision) and VisiPlate (Avisi), are undergoing trials with promising initial outcomes. The Calibreye implant is showing promising short-term data, with less patients experiencing unwanted side effect of bleb needling and while offering the ability to titrate to maximize patient benefit. An upcoming device, GORE glaucoma drainage device implant is showing promises preclinical results and offer unique device material composition.