In case of advanced glaucoma or when trabeculectomy fails, the most suitable therapy is a surgery with an implant of draining valves like theAhmed valve (the most common one).
Other draining valves are the Molteno shunt or the Baerveldt implant, that keeps the ocular pressure at acceptable levels through a small tube inserted in the eye.
These surgeries have to be performed by someone who gained experience in certified glaucoma centers. Dr. Badalà performs this surgery only in Milan.
The Ahmed valve can be used only for cases that are extremely complex that are not curable via other therapies.
The Ahmed valve implant is often requested for patient with the Boston Artificial Cornea.
Finally, we’d like to remember that, when this approach fails too, there are other options available: the problem is that these options may damage the ocular bulb functionality, like the ciliary body criotherapy.