Single long scleral tunnel technique for prevention of Ahmed valve tube exposure

Abstract

Purpose:

To evaluate the outcome of single long scleral tunnel technique for the prevention of conjunctival erosions caused by the Ahmed glaucoma valve.

Methods:

This study was a retrospective case series that included 30 eyes of 30 patients who underwent glaucoma valve implantation surgery by the single long scleral tunnel technique.

Results:

The mean age of patients at the time of surgery was 52 ± 21.6 years (range: 10–90 years). The mean visual acuity was 1.5 ± 0.81 logMAR preoperatively. The intraocular pressure was 40.7 ± 9.18 mm Hg (range: 25–58) before surgery that decreased significantly to 19.7 ± 3.1 mm Hg (range: 14–25; p < 0.0001) after a mean follow-up of 37.2 ± 5.9 months. During follow-up, no case of tube exposure was detected in patients.

Conclusion:

Single long scleral technique was efficacious with no occurrence of tube exposure in relatively long period of follow-up. In this method, there is no need to harvest any additional material, and in situations with limited access to patch grafts, it is performable with the minimal facilities.

Keywords

Ahmed glaucoma valve tube exposure scleral tunnel

Get full access to this article

View all access options for this article.

References

Ramulu

Corcoran

et al . Utilization of various glaucoma surgeries and procedures in Medicare beneficiaries from 1995 to 2004. Ophthalmology 2007; 114: 2265–2270.

Hong

Arosemena

Zurakowski

et al . Glaucoma drainage devices: a systematic literature review and current controversies. Surv Ophthalmol 2005; 50: 48–60.

Gedde

Heuer

Parrish

et al . Review of results from the tube versus trabeculectomy study. Curr Opin Ophthalmol 2010; 21: 123–128.

Minckler

Francis

Hodapp

et al . Aqueous shunts in glaucoma: a report by the American Academy of Ophthalmology. Ophthalmology 2008; 115: 1089–1098.

Kalenak

. Revision for exposed anterior segment tubes. J Glaucoma 2010; 19: 5–10.

Heuer

Budenz

Coleman

. Aqueous shunt tube erosion. J Glaucoma 2001; 10: 493–496.

Ainsworth

Rotchford

Dua

et al . A novel use of amniotic membrane in the management of tube exposure following glaucoma tube shunt surgery. Br J Ophthalmol 2006; 90: 417–419.

Sarkisian

Jr . Tube shunt complications and their prevention. Curr Opin Ophthalmol 2009; 20: 126–130.

Stewart

Kristoffersen

Demos

et al . Incidence of conjunctival exposure following drainage device implantation in patients with glaucoma. Eur J Ophthalmol 2009; 20: 124–130.

10.

Huddleston

Feldman

Budenz

et al . Aqueous shunt exposure: a retrospective review of repair outcome. J Glaucoma 2013; 22: 433–438.

11.

Lama

Fechtner

. Tube erosion following insertion of a glaucoma drainage device with a pericardial patch graft. Arch Ophthalmol 1999; 117: 1243–1244.

12.

Quaranta

Riva

Floriani

. Outcomes of using a sutureless bovine pericardial patch graft for Ahmed glaucoma valve implantation. Eur J Ophthalmol 2013; 23(5): 738–742.

13.

Tamcelik

Ozkok

Sarıcı

et al . Tenon advancement and duplication technique to prevent postoperative Ahmed valve tube exposure in patients with refractory glaucoma. Jpn J Ophthalmol 2013; 57: 359–364.

14.

Spierer

Waisbourd

Golan

et al . Partial thickness corneal tissue as a patch graft material for prevention of glaucoma drainage device exposure. BMC Ophthalmol 2016; 16: 20.

15.

Ollila

Falck

Airaksinen

. Placing the Molteno implant in a long scleral tunnel to prevent postoperative tube exposure. Acta Ophthalmol Scand 2005; 83: 302–305.

16.

Kugu

Erdogan

Sevim

et al . Efficacy of long scleral tunnel technique in preventing Ahmed glaucoma valve tube exposure through conjunctiva. Semin Ophthalmol 2015; 30(1): 1–5.