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Aim To compare the hazard of postoperative cystoid macular oedema (CME) between trabeculectomy and tube shunt implantation, focusing exclusively on non-diabetic patients to minimise confounding factors.Methods This is a retrospective cohort study using the TriNetX United States Collaborative Network. Patients with glaucoma who underwent trabeculectomy or tube shunt surgery were identified via International Classification of Diseases, 10th Revision and Current Procedural Terminology codes. Propensity score matching (PSM) was used to balance baseline characteristics. The primary outcome was the hazard of CME at 1 and 3 months postoperatively. Adjusted HRs (aHRs) were calculated using Cox proportional hazards models.Results After 1:1 PSM, 2928 patients were included in each cohort. At 1 month, CME was significantly less frequent in the trabeculectomy group (1.15%) compared with the tube shunt group (1.85%) (p=0.02). This difference widened at 3 months, with CME rates of 2.19% in the trabeculectomy group vs 4.20% in the tube group (p<0.0001). Trabeculectomy was associated with a 35% reduction in CME hazard at 1 month (aHR: 0.64; 95% CI 0.44 to 0.94; p=0.023) and a 45% reduction at 3 months (aHR: 0.55; 95% CI 0.42 to 0.72; p<0.0001) compared with tube shunt surgery. Male sex (aHR: 1.32), topical alpha agonist use (aHR: 1.61) and macular puckering (aHR: 2.75) were independently associated with increased CME risk.Conclusions Trabeculectomy is associated with a significantly lower hazard of postoperative CME compared with tube shunt surgery in non-diabetic glaucoma patients.