Glaucoma Surgery

Aetna covers laser trabeculoplasty for refractory primary open‑angle glaucoma after failure of first‑ and second‑line topical agents, FDA‑approved aqueous drainage/shunt implants (e.g., Ahmed, Baerveldt, Ex‑PRESS, Molteno, Krupin‑Denver, Schocket), up to two iStent trabecular micro‑bypass stents per eye and one Hydrus Microstent per eye when implanted concomitantly with cataract surgery in adults with mild–moderate open‑angle glaucoma who are on ocular hypotensive medication, and the XEN system for refractory glaucoma including prior surgical failures; transciliary filtration (e.g., Fugo Blade, Singh) is considered experimental/investigational and not covered. More than two iStents or more than one Hydrus are excluded, and iStent/Hydrus use is contraindicated in specified angle‑closure and secondary glaucoma types and other conditions (e.g., elevated episcleral venous pressure, thyroid eye disease, Sturge‑Weber for iStent; anterior chamber angle birth defects, malignant/traumatic/uveitic glaucoma for Hydrus).