Treatment Overview
Aqueous Shunt Implantation in Korea is an advanced glaucoma surgery designed to lower intraocular pressure (IOP) by diverting aqueous humor from the anterior chamber to a drainage reservoir formed under the conjunctiva. These implants—often called glaucoma drainage devices (GDDs) or tube shunts—help control pressure in patients with moderate to severe glaucoma who do not respond adequately to medications, laser therapy, or earlier surgeries.
Korean glaucoma specialists are global leaders in implanting shunts such as Ahmed valves, Baerveldt implants, and Molteno devices, utilizing AI-guided surgical planning, OCT-based tube positioning, and anti-scarring protocols to maximize safety, long-term stability, and visual outcomes.
Purpose & Benefits
Purpose
- Provide long-term IOP reduction in severe or refractory glaucoma.
- Allow aqueous humor to bypass the natural drainage pathways.
- Prevent further optic nerve damage when medications or laser treatments are insufficient.
- Offer a reliable treatment option for patients unsuitable for trabeculectomy.
Benefits
- Strong IOP Reduction: Effective even in advanced glaucoma.
- Long-Term Stability: Drainage devices provide durable pressure control.
- Works When Other Treatments Fail: Ideal for complex or post-surgical eyes.
- Customizable Flow: Valve or non-valve options provide controlled outflow.
- Lower Early Complication Risk: Particularly with valved devices (Ahmed).
- Suitable for Multiple Glaucoma Types: Neovascular, uveitic, congenital, traumatic, pigmentary, and more.
Ideal Candidates
Aqueous shunt implantation in Korea is ideal for:
- Patients with moderate to severe or refractory glaucoma.
- Eyes unresponsive to medications, SLT, or MIGS.
- Individuals who experienced failed trabeculectomy or filtering surgery.
- Patients with complex secondary glaucomas, such as:
- Neovascular glaucoma
- Uveitic glaucoma (controlled inflammation)
- Pediatric / congenital glaucoma
- Aphakic glaucoma
- Traumatic glaucoma
- Individuals requiring significant long-term pressure control.
Possible Risks & Complications
While aqueous shunts are highly effective, potential risks include:
- Hypotony (low pressure): Often temporary, especially with valved implants.
- Tube exposure or erosion: Prevented with scleral patch grafts.
- Bleeding or inflammation: Typically mild and manageable.
- IOP spikes (rare): Stabilized through medication adjustments.
- Corneal decompensation: Reduced using modern positioning techniques.
- Fibrosis around the plate: Managed using Korean anti-scarring protocols.
Korean clinics mitigate risks with AI-assisted tube positioning, imaging guidance, and enhanced postoperative care.
Types of Aqueous Shunt Surgeries in Korea
Ahmed Glaucoma Valve (Valve-Based)
Controls outflow automatically through valve mechanism, reducing early hypotony.
Baerveldt Implant (Non-Valved)
Offers powerful, long-term IOP lowering—ideal for severe or refractory cases.
Molteno Implant
One of the earliest and still effective multi-plate drainage systems.
Pediatric Glaucoma Shunts
Customized implants for congenital and juvenile glaucoma.
Combined Cataract + Shunt Surgery
Performed when patients need cataract removal alongside advanced glaucoma control.
Surgical Techniques
AI-Guided Surgical Planning
Determines optimal shunt type, plate location, and tube entry point.
Conjunctival Peritomy
Allows access to the sclera for plate positioning.
Implant Placement
Plate is secured to the sclera, typically in the superior quadrant.
Tube Insertion
Tube inserted into the anterior chamber, sulcus, or vitreous cavity depending on anatomy.
Scleral Patch Graft
Protects the tube and prevents erosion.
Flow Modulation
Ligation or venting slits (for non-valved implants) ensure controlled early healing.
OCT-Guided Positioning
Ensures proper tube distance from the cornea and iris.
Treatment Process in Korea
Step 1 – Full Glaucoma Evaluation
Includes IOP measurement, OCT, gonioscopy, visual fields, and anterior chamber imaging.
Step 2 – Implant Selection & Planning
Surgeon selects valve or non-valve device based on disease severity and patient factors.
Step 3 – Aqueous Shunt Implantation
Plate attached, tube inserted, patch graft applied, and flow regulated.
Step 4 – Immediate Postoperative Care
Anti-inflammatory drops started; IOP monitored frequently.
Step 5 – Long-Term Follow-Up
IOP stabilizes as bleb forms around the plate, with ongoing evaluations.
Treatment Duration: 45–60 minutes
Setting: Advanced eye surgery center or hospital operating room
Recovery & After-Care
After-Care Guidelines
- Use antibiotic and anti-inflammatory drops for several weeks.
- Avoid eye rubbing, bending, and strenuous activity.
- Wear protective eyewear during sleep initially.
- Follow medication adjustments to maintain stable IOP.
- Attend all follow-up visits for tube and bleb evaluation.
- Use lubricating drops if dryness occurs.
Recovery Timeline
- Days 1–3: Mild discomfort, redness, or blurred vision.
- Weeks 1–2: IOP begins to stabilize; inflammation decreases.
- Weeks 3–6: Plate encapsulation develops; device becomes fully functional.
- Months 2–6: Long-term IOP reduction achieved.
Results & Longevity
Expected Results
- Substantial and sustained reduction in intraocular pressure.
- Reliable outcomes even for advanced or high-risk glaucoma.
- Reduced reliance on glaucoma medications.
- Improved optic nerve protection over time.
Longevity
- Aqueous shunts typically last 10–20+ years.
- Korea’s advanced anti-fibrotic and imaging-guided techniques enhance longevity.
- Shunts can be revised or combined with other glaucoma procedures if needed.
Why Korea Is a Top Destination
- World-renowned glaucoma surgeons experienced with all major shunts.
- AI-enhanced surgical planning for precise implant placement.
- Advanced imaging systems (OCT/UBM) for tube positioning and monitoring.
- Low complication rates due to refined techniques and superior postoperative care.
- Excellent outcomes even in complex or refractory glaucoma cases.
Unique Korean Innovations
- AI-optimized tube entry points to protect cornea and iris.
- Customized anti-scarring protocols to improve long-term implant function.
- High-definition OCT verification during and after surgery.
- Hybrid implant + MIGS solutions for multi-mechanism pressure control.
- Predictive algorithms for long-term IOP behavior and device performance.
Cost Range (Indicative Estimate)
| Treatment Package | Price (KRW) | Approx. USD | Inclusions |
|---|---|---|---|
| Standard Aqueous Shunt Implantation (Ahmed) | ₩4,200,000 – ₩6,000,000 | ~$3,100 – $4,500 | Valve implant + tube placement + routine care |
| Baerveldt or Molteno Implant | ₩4,800,000 – ₩7,500,000 | ~$3,600 – $5,700 | Large-plate implant + anti-scarring care |
| Pediatric Shunt Surgery | ₩5,500,000 – ₩8,500,000 | ~$4,100 – $6,400 | Child-specific implant + extended monitoring |
| Cataract + Shunt Combination | ₩7,500,000 – ₩10,500,000+ | ~$5,700 – $8,000+ | Phaco + implant + advanced postoperative care |
Popular Clinics in Korea
- B&VIIT Eye Center (Seoul) – Experts in valved and non-valved implants.
- Dream Eye Center (Seoul) – Specialists in high-risk glaucoma implant surgery.
- BGN Eye Clinic (Busan & Seoul) – Skilled in advanced and pediatric glaucoma shunts.
- Glory Seoul Eye Clinic – Known for OCT-guided tube placement.
- K-Cure Vision Center (Gangnam) – Leaders in AI-assisted glaucoma implant planning.
