Aqueous shunt implant surgery for refractory glaucoma

The newer generation of aqueous shunt implant for glaucoma filtration surgery has increased our ability to manage more successfully glaucoma refractory or uncontrollable by medical therapy or standard surgical means. These clinical results suggest that surgery with such devices may even provide greater efficacy than standard filtration operations. The development of modern sophisticated device designs incorporating unidirectional valves has reduced complication and re-operation rates. Confidence in the use of these newer devices will increase as surgeons gain wider experience. Presently, some surgeons are considering aqueous shunt implant procedures before resorting to adjunctive antimetabolites to avoid scleral degeneration that may limit subsequent shunt surgery. Although glaucoma remains a disorder without a cure, the advent of aqueous shunt implants for glaucoma filtration surgery has greatly increased the prognosis for this visually threatening disorder.