Intraocular pressure
Refractory glaucoma with inadequate IOP control on tolerated treatment.
About the service
Glaucoma drainage procedures improve aqueous outflow and lower eye pressure. The operation and device are selected according to glaucoma characteristics and scarring risk.
Who the service is for
Scarring
Repeat glaucoma surgery after a failed or scarred filtration procedure. Eyes with high conjunctival-scarring risk after previous surgery, inflammation or trauma.
Secondary glaucoma
Secondary glaucomas in which standard filtration surgery is less predictable.
Neovascular and uveitic glaucoma
Neovascular or uveitic glaucoma after disease activity has been stabilised and risks assessed.
Glaucoma associated with an altered crystalline-lens condition
Selected aphakic, pseudophakic, post-traumatic or post-keratoplasty glaucoma.
Glaucoma and eye pressure
Refractory paediatric/congenital glaucoma only through a specialist paediatric surgical pathway.
Choosing the surgical approach
Drainage surgery is an intraocular intervention. Possible complications include hypotony or insufficient IOP reduction, bleeding, inflammation, infection, scarring, tube displacement or obstruction, contact between the tube and cornea, endothelial damage, conjunctival erosion over the tube, double vision and the need for repeat surgery. Risks depend on the device, anatomy and previous operations.
Determining the mechanism of glaucoma
Bring previous IOP measurements, pachymetry , gonioscopy, visual fields, optic nerve/RNFL OCT, operative reports and a complete medication list. Do not stop glaucoma drops, anticoagulants or systemic medicines on your own. Device selection depends on conjunctival scarring, previous surgery, glaucoma type, corneal status, lens status, retinal disease and the required target IOP.
Limitations and safety
Drainage surgery is an intraocular intervention. Possible complications include hypotony or insufficient IOP reduction, bleeding, inflammation, infection, scarring, tube displacement or obstruction, contact between the tube and cornea, endothelial damage, conjunctival erosion over the tube, double vision and the need for repeat surgery. Risks depend on the device, anatomy and previous operations. Seek urgent assessment for severe pain, sudden visual loss, marked redness, discharge or if part of the implant becomes visible.
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Stages
Stage 1
Preoperative assessment
Glaucoma type, target pressure, OCT, visual fields, gonioscopy, cornea, crystalline lens and conjunctiva.
Stage 2
Selecting surgery and device
The surgeon decides whether drainage is needed and which type suits the eye.
Stage 3
Diagnostic protocol
Anaesthetic preparation and surgical-field preparation according to current KazRIED protocol.
Stage 4
Choosing the surgical approach
Creation of surgical access and implantation of drainage material or a tube shunt according to the selected technique.
Stage 5
Implant monitoring
Assessment of implant position, aqueous flow and tissue closure.
Stage 6
Early postoperative follow-up
Pressure, anterior chamber, cornea, conjunctiva and signs of inflammation or infection.
Stage 7
Long-term follow-up
Drop adjustment, implant assessment and serial OCT and visual fields.
Service benefits
An additional drainage route
A drainage device creates a route for aqueous fluid to leave the eye, helping control pressure.
An option for selected complex cases
A drainage device may be chosen when other operations have limited effectiveness or a high risk of scarring.
A focus on target pressure
The surgical approach is selected according to the pressure needed to protect the individual optic nerve.
Managing the postoperative outcome
Scheduled examinations allow healing and pressure to be monitored and treatment adjusted when needed.
Book an appointment
The surgeon will review target IOP, rate of progression, optic nerve status, previous operations and conjunctival condition and explain whether a drainage device, trabeculectomy, non-penetrating deep sclerectomy (NPDS), laser treatment or another route is more appropriate.
Procedure prices
Service name
Price
Trabeculectomy, (per eye)
from 247 000 ₸
Trabeculectomy with Glautex, (per eye)
from 535 000 ₸
Surgery with Repegel drainage, (per eye)
from 328 000 ₸
Phaco + trabeculectomy, (per eye)
from 496 000 ₸
Pre/post-op ophthalmologist monitoring, (per consultation)
from 32 500 ₸
Surgical inpatient day, (per bed-day)
from 19 500 ₸
Our doctors
A team of experienced doctors across specialties.
Experience: 26 years
Head
Zhakybekov Ruslan Adilovich
Candidate of Medical Sciences; Highest-category ophthalmologist
Experience: 31 years
Head
Zhurgumbaeva Gulnar Kayratovna
Candidate of Medical Sciences; Highest-category ophthalmologist
Experience: 26 years
Ophthalmologist
Tuletova Aygerim Serikbaevna
Candidate of Medical Sciences; Highest-category ophthalmologist
Experience: 13 years
Ophthalmologist
Kalshabekov Alibi Sembaevich
Highest-category ophthalmologist
Experience: 12 years
Ophthalmologist
Tadzhimetov Murat Mikhaylovich
Highest-category ophthalmologist
Experience: 17 years
Ophthalmologist
Tokymbaeva Zhenisgul Nurmankyzy
Highest-category ophthalmologist
Experience: 6 years
Ophthalmologist
Berikbay Gulzat Talghatqyzy
Second-category ophthalmologist
Experience: 9 years
Ophthalmologist
Kalmurzaev Kanat Kayratuly
Second-category ophthalmologist
Glaucoma drainage devices: how they work and postoperative monitoring
A glaucoma drainage device helps divert aqueous humor around an inadequately functioning natural drainage system. Its design and mechanism depend on the device type.
How do drainage systems differ?
With a tube shunt, one end of the tube communicates with the anterior chamber, ciliary sulcus, or, in selected cases, the vitreous cavity. The plate or reservoir is positioned beneath the conjunctiva.
Valved systems use a built-in mechanism to restrict early flow. Nonvalved systems require surgical measures to control flow.
Another category includes bioresorbable materials and spacers, such as Glautex. These are used at the filtration site to reduce the risk of tissue adhesion.
Which procedures are listed at KazRIED?
KazRIED’s current price list includes trabeculectomy with Glautex and surgery using a Repegel drainage implant.
Implantation of various drainage devices is also mentioned in the day hospital description, while glaucoma drainage surgery is listed in the description of the Astana clinic.
How is a drainage device selected?
Valved and nonvalved tube shunts, as well as bioresorbable drainage implants, serve different purposes. The choice depends on:
- previous surgical procedures;
- the risk of scarring;
- anterior segment anatomy;
- corneal condition;
- the required intraocular pressure (IOP) level.
What is the goal of surgery?
A drainage device does not restore visual field that has already been lost. Its purpose is to create or maintain an additional pathway for aqueous humor outflow and help achieve an individualized target IOP.
The main measure of effectiveness is safely achieving the target IOP and preventing progression of glaucomatous optic neuropathy.
Monitoring after implantation
Long-term follow-up is needed after implantation. Early monitoring includes IOP, tube position or the condition of the filtration site, and the anterior chamber, cornea, and conjunctiva.
Later assessments evaluate the optic nerve and visual field. Glaucoma remains a chronic disease even when pressure is well controlled. Some patients may need eye drops, additional procedures, or further surgery.
Surgery and subsequent monitoring are considered parts of a single treatment process.
Facts and offers
Kazakhstan’s first specialized ophthalmology institute, operating since 1933.
Modern diagnostics and surgery using world-class equipment.
Leading ophthalmologists in Kazakhstan, scientists and experienced surgeons.
More than 30,000 operations and around 270,000 consultations annually.
Kazakhstan’s first specialized ophthalmology institute, operating since 1933.
Modern diagnostics and surgery using world-class equipment.
Leading ophthalmologists in Kazakhstan, scientists and experienced surgeons.
More than 30,000 operations and around 270,000 consultations annually.
Kazakhstan’s first specialized ophthalmology institute, operating since 1933.
Modern diagnostics and surgery using world-class equipment.
Leading ophthalmologists in Kazakhstan, scientists and experienced surgeons.
More than 30,000 operations and around 270,000 consultations annually.
Related services
Frequently asked questions
What is a glaucoma drainage device?
It is an implanted device that creates an alternative pathway for aqueous drainage and helps lower intraocular pressure. Conventional devices usually consist of a tube entering the eye and a plate positioned outside the globe beneath the conjunctiva.
When is a drainage device considered instead of trabeculectomy?
Drainage-device surgery is often considered in refractory or selected secondary glaucomas, after failed filtration surgery, with significant conjunctival scarring or when conventional filtration surgery has a high risk of failure.
Can a glaucoma drainage device restore lost vision?
No. Optic-nerve damage already caused by glaucoma is generally irreversible. Surgery aims to lower IOP and reduce the risk of further visual loss.
What is a valved glaucoma drainage device?
It is a tube-and-plate implant with an integrated mechanism that restricts excessive flow at low pressure. The valve reduces, but does not eliminate, the risk of significant early hypotony.
What is a non-valved glaucoma drainage device?
It is a tube-and-plate implant without an integrated valve. Early aqueous flow is temporarily restricted by surgical techniques to reduce the risk of excessive postoperative hypotony.
How does drainage-device surgery differ from trabeculectomy?
Trabeculectomy creates a filtration pathway through the eye’s tissues with formation of a filtering bleb. A drainage device directs aqueous through an implanted tube toward a plate positioned beneath the conjunctiva.
Why does a glaucoma implant have a tube and a plate?
The tube carries aqueous out of the eye, while the plate provides an area around which a reservoir forms and fluid is subsequently absorbed by surrounding tissues. Device size and design vary by model.
Are all glaucoma drainage devices the same?
No. Devices differ in valve design, plate size and material, tube construction and other characteristics. Both valved and non-valved systems are available, and selection depends on the clinical situation.
How is a glaucoma drainage device selected?
Selection considers glaucoma type and stage, the required degree of IOP reduction, previous surgery, conjunctival and corneal health, scarring risk, anterior-segment anatomy and other individual factors.
Are OCT and visual-field tests needed before surgery?
These tests are often important for assessing glaucoma severity, optic-nerve status and disease progression. The exact preoperative testing plan depends on the individual case.