Outcomes of Drainage Device Surgery in Uveitic Glaucoma: Systematic Review and Meta-Analysis

In this meta-analysis of 1083 eyes with UG, GDDs achieved the overall surgical success rate of 65.40%, with AGVs demonstrating the greatest IOP reduction and BGIs requiring fewer postoperative medications.

This study aimed to compare the effectiveness and complication profiles of different types of glaucoma drainage devices (GDDs) in patients with uveitic glaucoma (UG).

A comprehensive literature search across PubMed, Web of Science, Cochrane Library, and Embase identified relevant GDD implantation studies in UG through October 12, 2025. Literature screening, data extraction, and quality assessment were implemented using EndNote, followed by meta-analyses through "meta" package in R software (version 4.3.0).

Thirty-eight studies (1083 eyes) were analyzed. The meta-analysis indicated a remarkable drop in intraocular pressure (IOP) across all GDD types postoperatively. Among these, the Ahmed glaucoma valves (AGVs) presented the greatest IOP reduction than other devices [MD = -28.87, 95% CI: (-38.38, -19.36)]. Postoperative use of topical IOP-lowering medications declined universally across all devices, with the Baerveldt Glaucoma Implants (BGIs) again showing the most pronounced reduction [MD=-5.28, 95% CI (-8.40, -2.15)]. In the comparative analysis between AGVs and BGIs, the BGIs group required fewer postoperative IOP-lowering medications than the AGVs group. The overall surgical success rate post-GDD implantation was 65.40% (95% CI: 54.90%-74.60%), with complete success and qualified success rates of 36.40% (95% CI: 25.40%-49.00%) and 40.30% (95% CI: 25.60%-56.90%). Postoperative complications included elevated IOP in 22.70% and hypotony in 18.40% of AGV-implanted eyes.

Ahmed, Baerveldt, Molteno, and PAUL Glaucoma Implant are effective surgical options for UG management. However, current evidence remains scarce for novel devices, and the differences in efficacy and complication profiles among devices warrant consideration in individualized treatment planning.