Abstract： Tube shunt or glaucoma drainage device is often used in refractive cases when prior medical or surgical therapy has failed.With improving the biocompatibility of devices'materials and surgical technique,indications for tube shunt have broadened.This article discusses the update topic that could tube shunt be as initial surgery for glaucoma management? Based on large varieties of previously published results,tube shunt can be the first choice for refractive glaucoma,however,at prevent there still lack of strong evidences from multi-center randomized clinical trials especially from domestic research to support that tube shunt can substitute primary trabeculectomy for expanded use beyond refractory glancoma.