Strategy of choosing a drainage device for the surgical treatment of refractory glaucoma

Abstract. Objective: to determine the tactics of choosing a drainage device, as well as to identify early postoperative complications in the implantation of certain types of drainage. Material and methods. The patients were divided into 3 groups depending on the drainage used: group 1 —Ahmed valve (16 eyes, 24.6%), group 2 — Ex-press metal anti-glaucoma shunt (27 eyes, 42.5%), group 3 — drainage BenchmarkA-1 (22 eyes, 32.9%). Results. In 11 eyes (15%), hyphema was observed on the first day, which resolved on its own on the 3rd day. Ciliochoroidal detachment on the first day after surgery was detected in group 1 (1 eye), group 2 (5 eyes), group 3 (4 eyes). Increased intraocular pressure on the 1st day after surgery was detected in 3 eyes in patients of the 3rd group. Drainage antiglaucoma Reper A-1 is preferably implanted in eyes with primary glaucoma with an unsatisfactory result of surgery on the fellow eye and in eyes with postveal glaucoma. The Ex-press shunt has a good hypotensive effect in advanced operated high-pressure glaucoma in combination with pseudophakia. The preference for Ahmed valve implantation is given to secondary refractory uncompensated glaucoma with residual visual functions. Conclusion. The use of shunts and drainage devices is a modern approach to achieve target intraocular pressure in patients with refractory glaucoma, which will preserve visual functions, prevent disability and avoid blindness.