PURPOSE: This study evaluated the short-term efficacy and safety of the A-stream Glaucoma Shunt (A-stream
MICROT Inc., Republic of Korea) in patients who completed 6 months of follow-up after implantation. METHODS: Medical records of 49 patients (49 eyes) who underwent A-stream implantation between October 2023 and February 2024 were retrospectively reviewed. Primary outcomes included surgical success and intraocular pressure (IOP) reduction at 6 months postoperatively. Success was defined as achieving an IOP ≤ 18 mmHg, with at least a 20% reduction from preoperative IOP, and without clinically significant hypotony (IOP <
6 mmHg persisting >
1 month or with hypotony maculopathy), classified as qualified (with or without medications) or complete (without medications). Ripcord removal timing and its effect on IOP, postoperative interventions, and complications were analysed. RESULTS: At 6 months, the mean IOP significantly decreased from 26.9 ± 8.3 mmHg to 11.9 ± 3.5 mmHg (P <
0.01). Complete success was achieved in 77.6% and qualified success in 93.9% of the eyes. The ripcord was removed in 73.5% of eyes at an average of 1.8 ± 1.3 months postoperatively, which led to further IOP reduction of 6.8 ± 5.0 mmHg 1 month after removal. No cases of clinically significant hypotony or vision-threatening complications were observed. CONCLUSIONS: The A-stream demonstrated excellent short-term efficacy and safety in lowering IOP with high success rates. The ripcord enabled controlled IOP adjustments postoperatively. Further studies are warranted to evaluate long-term outcomes and compare them with conventional surgeries.