Early postoperative complications are common after tube shunt surgery, but most are transient and self-limited. It is not surprising that glaucoma procedures that produce greater IOP reduction also have a higher risk of hypotony-related sequelae. Unfortunately, a trade-off exists between efficacy and safety with currently available glaucoma operations. Patients with advanced and/or progressive glaucoma benefit from aggressive IOP reduction with traditional glaucoma surgery, as glaucoma procedures that produce greater IOP reduction are more likely to stabilize the disease. Early recognition and appropriate treatment of early tube complications can optimize patient outcomes.