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Abstract

This case report presents the management of refractory glaucoma in a middle-aged patient with a familial history of primary open-angle glaucoma (POAG). The patient had previously received two trabeculectomies in the right eye with persistently elevated intraocular pressure (IOP) despite maximal medical therapy. The results showed that there was advanced glaucomatous damage and an IOP of 43.4 mmHg (NCT). Due to financial constraints, Virna Glaucoma Implant (VGI) was selected as a low-cost drainage device. Postoperative IOP on Day 18 was 10 mmHg with a best-corrected visual acuity (BCVA) of 6/7, and by Day 32, IOP was 19 mmHg with BCVA of 6/8. The patient reported symptomatic relief and tolerated the implant well without complications or the need for additional medication. This case showed the potential of low-cost glaucoma implant as an effective alternative for managing refractory glaucoma in resource-limited settings, where access to high-cost surgical devices is limited.