a glaucoma implant as a primary procedure is indicated include Neovascular glaucoma – glaucoma associated with vascular disease of the eye (often diabetes). Cases of Uveitis – acute or chronic inflammation of the eye. Traumatic glaucoma – glaucoma associated with injury to the eye. Silicone glaucoma – glaucoma due to Silicone used to repair a detached retina. Infantile/Juvenile glaucoma – often associated with developmental defects of the eye. Surgical technique The flow tube is inserted into the anterior chamber of the eye and the plate is implanted underneath the conjunctiva to allow flow of aqueous fluid out of the eye. The first-generation Molteno and other non-valved implants sometimes require the ligation of the tube until the bleb formed is mildly fibrosed and water-tight. This is done to reduce postoperative hypotony – sudden drops in postoperative intraocular pressure (IOP). Valved implants such as the Ahmed glaucoma valve attempt to control postoperative hypotony by using a mechanical valve. Studies show that in severe cases of glaucoma, double plate Molteno implants are associated with lower mean IOP in the long term compared to the Ahmed glaucoma valve. Second and third generation Molteno implants incorporate a biological valve and studies show considerable improvement in postoperative outcome over the older style Ahmed and Molteno implants. Baervedlt shunts (non-valved) have been shown to have lower rates of surgical failure than Ahmed shunts (valved), this have may be related to the high rate of valve failure, or to the larger plate surface of the Baerveldt shunt. Complications The majority of complications occur shortly after surgery. These are generally related to high pressure (due to inflammation following surgery) or low pressure (too much aqueous flow through the tube). Periods of low pressure which are more associated with non-valved shunts, can cause retinal detachments, hypotony maculopathy or haemorrhages. Periods of high pressures, which are more associated with valved shunts, are detrimental to the optic nerve. Long term complications of this surgery include diplopia and corneal oedema. There are also device related complications, which will require surgical revision. For example, erosion, where the conjunctiva erodes over the shunt leaving it exposed, the condition of which may be revised or prevented in advance by the use of amniotic membrane, The ologen collagen matrix facilitates tissue regeneration and its application over the site of device implantation can strengthen tissue recovery, reducing possibility of erosion. When the device malfunctions it may need to