Glaucoma Drainage Implants for Uveitic Glaucoma

Uveitic glaucoma (UG) is a complex secondary glaucoma caused by intraocular inflammation that disrupts aqueous humor drainage, leading to increased intraocular pressure (IOP) and potential vision loss. While medical therapy is the first-line treatment, glaucoma drainage implants (GDIs) become essential when pharmacologic management fails. Common GDIs, including the Ahmed Glaucoma Valve (AGV), Baerveldt Glaucoma Implant (BGI), and Molteno implant, play a critical role, particularly in cases with chronic inflammation. Successful GDI surgery requires meticulous preoperative planning, with strict inflammation control being paramount. Device selection is crucial, with valved implants (e.g., Ahmed Glaucoma Valve) often preferred for better IOP regulation and lower hypotony risk. Surgical techniques must consider conjunctival handling, incision approach, and implant positioning to optimize outcomes. Postoperative management focuses on inflammation control, IOP monitoring, and wound healing. Potential complications, such as hypotony, a hypertensive phase, tube occlusion, erosion, and infection, necessitate prompt intervention. Advancements in surgical approaches, including novel biomaterials, microshunts, minimally invasive glaucoma surgery (MIGS), and drug-eluting implants, aim to enhance safety and efficacy. GDIs remain a cornerstone in the management of uveitic glaucoma, necessitating individualized treatment strategies and continued innovation.