Glaucoma drainage implants in pediatric patients.

Approximately, one fifth of primary congenital glaucoma patients fail primary surgery. Also, some pediatric glaucomas respond poorly to goniotomy or trabeculectomy. In these situations, clinicians often choose trabeculectomy with mitomycin-C or a drainage implant as a surgical treatment. Glaucoma drainage device implantation is a useful option in refractory patients. When other surgical treatments have a poor prognosis for success, prior conventional surgery fails, or significant conjunctival scarring precludes filtration surgery, glaucoma drainage implant may effectively control intraocular pressure. Patients often require adjunctive glaucoma medications after surgery and may develop complications. Most of these complications, however, are reversible or resolve spontaneously, and most are not associated with vision loss.