Primary congenital aphakia is extremely rare and almost always associated with intractable glaucoma. We demonstrate a novel technique to flush the drainage tube without traction on the abnormal vitreous associated with this rare condition. This is done by a transluminal approach of the drainage tube prior to entry into the eye. Linear ultrasound scan identified vitreous wick in the intraocular portion of the tube, and anterior segment optical coherence tomography showed reduced drainage via the base plate. The tube was exposed on its episcleral portion and incised into its lumen with a 30-gauge needle to create a one-way valved incision. A 30-gauge cannula was inserted through this incision to irrigate toward the shunt's plate, obtaining bleb elevation and thus ensuring a functional shunt posterior to the incision. Then, the 30-gauge cannula was passed through the incision while irrigating this time toward the distal part of the tube to free it from potential vitreous adhesions. This external-to-internal approach avoids generating traction on the delicate vitreous and makes for safe anterior chamber manipulation in a situation where intense corneal opacity does not allow visualization.