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Abstract Refractory glaucoma is a type of glaucoma which is uncontrollable by medical therapy and/or conventional filtration procedures with or without cyclodestructive and/or laser treatments. The refractory glaucoma includes uveitic glaucoma, NVG, advanced congenital or infantile glaucoma, aphakia and pseudophakia glaucoma, traumatic glaucoma, PK glaucoma, glaucoma after retinal detachement surgery, irido-corneal endothelial syndrome, epithelial ingrowth and failed previous filter surgery. GDDs are a useful alternative in treating glaucoma that are resistant to medical therapy and glaucoma filtration surgery. Several GDDs have been developed to treat refractory glaucoma. Among these are Krupin, Molteno, Sochecket, AGV and Baerveldt implants, unlike Molteno and Baerveldt implants, AGV has a unidirectional valve designed to prevent postoperative hypotony. Factors that influence the choice of shunt to be implanted are shunt related factors as Surface area, plate material, and valved versus non valved and patient factors as severity of glaucoma damage, tolerance of topical hypotensive medication, aqueous hyposecretion, previous ocular surgery, and scleral thinning. |