Aqueous Shunts and Stents for Glaucoma

This policy covers implantation of FDA‑approved aqueous drainage devices — ab externo shunts and ab interno microstents — to lower intraocular pressure in patients with glaucoma, including placement of 1–2 ab interno stents at the time of cataract surgery for adults with mild‑to‑moderate open‑angle glaucoma on ocular hypotensive medication. Coverage is limited to cases where target IOP cannot be achieved with medical therapy (and, for some devices, after failed surgical treatment); device‑specific approvals/restrictions apply (e.g., iStent limited to use with cataract surgery, iStent infinite only after medical and surgical failure), some devices have been recalled or remain unapproved (CyPass recalled; PRESERFLO pending), and shunts/stents may be inadequate when very low IOP is required or for indications outside their labeling.

"Insertion of FDA‑approved ab externo aqueous shunts to reduce intraocular pressure in individuals with glaucoma when medical therapy has failed to adequately control intraocular pressure."