Ahmed ClearPath is a next-generation non-valved glaucoma drainage device that lowers intraocular pressure in refractory glaucoma by routing aqueous fluid from inside the eye to a bleb under the conjunctiva over a smooth silicone plate. At Eye Surgery Clinic partner clinics, consultant-led Ahmed ClearPath surgery is performed as a 60–90 minute day case under local anaesthetic and sedation, with self-pay pricing from £7,200 per eye for the ClearPath 250 and £7,600 for the larger ClearPath 350. All prices are all-inclusive of theatre, the implant, anaesthetist and a structured 12-month aftercare pathway.
What is an Ahmed ClearPath glaucoma drainage device?
The Ahmed ClearPath is a glaucoma drainage device (GDD) manufactured by New World Medical and is the latest evolution of the Ahmed tube-shunt platform. Unlike the original Ahmed Valve, ClearPath is non-valved — the same family as the Baerveldt and PAUL implants — and is designed for lower long-term intraocular pressures (IOP) in refractory glaucoma. The implant has a smooth, low-profile silicone plate that sits under the conjunctiva and Tenon's capsule on the sclera, with a small flexible silicone tube that enters the anterior chamber to drain aqueous humour to a bleb over the plate.
A drainage tube is the surgical option for glaucoma when intraocular pressure remains too high despite maximal drops, selective laser trabeculoplasty (SLT), sustained-release implants such as the iDose TR, minimally-invasive glaucoma surgery (iStent, Hydrus Microstent, OMNI canaloplasty), and bleb-forming procedures such as the Preserflo MicroShunt or XEN gel stent. ClearPath sits alongside the PAUL glaucoma tube as the modern non-valved tube of choice.
Who is Ahmed ClearPath for?
- Refractory open-angle glaucoma with failed maximal medical therapy and previous SLT or MIGS
- Neovascular glaucoma after central retinal vein occlusion or proliferative diabetic retinopathy
- Uveitic glaucoma where prolonged steroid therapy has driven up intraocular pressure
- Failed trabeculectomy or failed previous bleb-forming surgery
- Iridocorneal endothelial syndromes and other secondary glaucomas where the conventional outflow is permanently damaged
- Post-keratoplasty or post-vitrectomy glaucoma where MIGS is not feasible
Pressure still uncontrolled despite drops, SLT or a MIGS device? A consultant glaucoma assessment with full optic-disc imaging will tell you whether a tube is the right next step.
Book a glaucoma assessmentPlate-size options
Ahmed ClearPath comes in two plate sizes. Your consultant will choose based on the conjunctival real-estate available, the target intraocular pressure and previous surgery.
Both Ahmed ClearPath plates are made of medical-grade silicone with a smooth surface and rounded edges designed to reduce conjunctival erosion and Tenon's capsule fibrosis compared to older polypropylene plates. Because ClearPath is non-valved, the surgeon ties an absorbable ripcord suture around the tube so the implant is occluded for the first 4–6 weeks, allowing a controlled bleb to form before drainage begins.
What happens during Ahmed ClearPath surgery
The procedure is performed as a day case under local anaesthetic with sedation in a fully-equipped ophthalmic operating theatre by a consultant glaucoma surgeon. Expect to be at the clinic for around 4 hours including pre-op checks, surgery and post-op observation.
- Sub-Tenon's local anaesthetic and intravenous sedation are given. The eye is cleaned and draped, and an eyelid speculum is placed.
- The surgeon creates a fornix-based conjunctival incision in the supero-temporal quadrant and dissects under Tenon's capsule down to bare sclera.
- The Ahmed ClearPath plate is sutured to the sclera 8–10 mm posterior to the limbus with 8-0 nylon sutures through the plate's fixation points.
- The silicone tube is trimmed to length, bevelled, and entered into the anterior chamber through a needle-tracked corneal entry, parallel to the iris and clear of the corneal endothelium.
- An occluding 7-0 Vicryl ripcord suture is tied around the tube; the tube is reinforced with a scleral or pericardial patch graft; conjunctiva is closed; and intracameral antibiotic is given.
Recovery week-by-week
Tube surgery has a longer healing curve than MIGS or bleb-forming surgery because the absorbable ripcord must dissolve before drainage opens up. Most patients are back to normal activities within four weeks, with full IOP stabilisation by 3–6 months.
Day of surgery
Eye shielded. Vision blurred and the eye feels gritty. No driving, no heavy lifting. Drops begin: steroid, antibiotic and any continuing pressure drops.
Week 1
First post-op review. Bleb is forming. Pressure may temporarily rise because the ripcord is still occluding the tube — this is expected and managed with drops.
Weeks 2–4
Return to most normal activities. No swimming and no eye rubbing. Continuing steroid drops to control inflammation.
Weeks 4–8
The Vicryl ripcord absorbs and the tube begins to drain. Intraocular pressure usually drops sharply at this point; pressure drops are tapered or stopped.
Months 3–12
Bleb matures and intraocular pressure stabilises. Steroid drops fully tapered. 3-monthly glaucoma reviews with optic-disc OCT and visual fields.
Cost & insurance
Our Ahmed ClearPath surgery prices are all-inclusive: consultant glaucoma assessment with OCT and visual fields, the surgery itself, theatre and hospital fees, anaesthetist, the implant of your surgeon's choice, post-op drops, and 12 months of structured glaucoma reviews. There are no hidden extras.
- Self-pay: from £7,200 per eye for ClearPath 250; £7,600 for ClearPath 350; £7,400 for PAUL implant.
- Insurance: recognised by Bupa, AXA, Aviva, Vitality, Cigna, WPA and others. Tube surgery for refractory glaucoma is normally covered; we handle pre-authorisation.
- Finance: 0% for 12 months — approximately £600/month for ClearPath 250.
Full glaucoma pricing is on our glaucoma price list and the private glaucoma surgery cost page; the wider glaucoma treatment hub explains where tube surgery fits in the overall pathway.