Glaucoma drainage device (GDD) is moderately successful in patients with refractory glaucoma. However, bleb fibrosis appears to be the major cause of long-term GDD failure. In recent years, many researchers tried to explain the cause of fibrosis and its influence on the clinical effects of GDD from histopathological study. It has reported that antifibrotic agents are effective in controlling capsule fibrosis around GDD, but this view has been challenged recently. Although GDD can effectively reduce the intraocular pressure (IOP) in refractory glaucoma, it is associated with many serious complications, such as endophthalmitis, corneal decompensation and hypotony. Because of the disadvantages of GDD, many new implant and modified surgical technique emerged in recent years. The anterior segment OCT is able to visualize the whole outline and the position of the tube, therefore it is useful for guiding the postoperative treatment. Furthermore, the application of novel materials and nanotechnology could open up new avenues for GDD.