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PURPOSE: To describe a previously unreported method for optimizing early intraocular pressure-lowering in non-valved aqueous shunt surgery, and to report pilot results from a case series. OBSERVATIONS: We report pilot results of 30 eyes that underwent Baerveldt-350 implantation with adjunctive goniotomy, in addition to 3 needle-puncture fenestrations, to enhance intraocular pressure lowering and facilitate higher steroid dosing before spontaneous ligature dissolution. CONCLUSIONS AND IMPORTANCE: In patients with open-angle glaucoma, goniotomy is a safe and effective procedure when performed in conjunction with non-valved glaucoma tube shunt implantation.
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