What is tube-shunt surgery?

Tube-shunt surgery (seton glaucoma surgery) involves placing a flexible plastic tube with an attached silicone drainage pouch in the eye to help drain fluid (aqueous humor) from the eye. This type of surgery is usually done after a trabeculectomy that failed. If a person already has or is likely to form scar tissue in the eye, this type of surgery may be done at the start.

Tube-shunt surgery can be done with the person asleep (general anesthesia) or with anesthetic applied only to the eye (local anesthesia).

Tube-shunt surgery is most often used for people who have had previous trabeculectomy surgery that was not successful, usually due to scarring.

Tube-shunt surgery is also frequently used to treat glaucoma when a person has a:

• Difficult case of glaucoma and the doctor thinks that other surgical methods may fail.
• Form of glaucoma in which new blood vessels grow on the colored part of the eye, or iris. This is called neovascular glaucoma and occurs primarily in people who have diabetes or who have vascular diseases in the eye. It is difficult to control.
• Corneal transplant, which is a surgery to replace the clear surface on the front of the eye (cornea).

More than half of tube-shunt surgeries are successful. This surgery has been shown to reduce intraocular pressure (IOP) and the need for further glaucoma treatment.