Abstract
Glaucoma drainage implant (GDI) insertion is among the most common incisional glaucoma surgery. In the United States, currently available GDIs include Ahmed valved glaucoma drainage implants, and non-valved devices including the Ahmed Clearpath, Baerveldt, and Molteno glaucoma drainage implants. Although GDIs were historically reserved for eyes with prior history of failed filtering procedures or deemed to be at high risk for trabeculectomy failure, the indications for GDIs continue to grow. In this chapter, the surgical technique and post-operative management of GDIs are reviewed. Complications of GDI placement–including scleral perforation, severing of the tube, hypotony, tube lumen obstruction, endplate or tube tip migration, exposure, encapsulation, corneal decompensation, and strabismus–are discussed. Evidence from randomized clinical trials comparing GDI versus trabeculectomy, as well as comparison among the different types of GDIs, are reviewed.