Polypropylene suture–guided valve tube for posterior chamber implantation in patients with pseudophakic glaucoma

Moreno-Montañés, Javier; Fantes, Francisco; García-Gómez, P.J.

doi:10.1016/j.jcrs.2008.05.063

Cited by 5 publications

(5 citation statements)

References 13 publications

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“…Asaoka et al reported that 42/91 eyes (46%) were not successfully placed to ciliary sulcus with a single attempt, and 4/91 eyes (4.4%) were unable to achieve ciliary sulcus insertion [3]. A technique for ciliary sulcus insertion has been reported using 10-0 nylon thread with straight needle to create a sliding knot, but the technique is complicated [4].…”

Section: Discussionmentioning

confidence: 99%

“…However, the low rigidity of AGV tube causes difficulties in insertion to ciliary sulcus, such as straying into the vitreous cavity or into an unidentifiable position, when using simple insertion methods [3]. Several techniques have been reported to overcome these problems, although problems remain, such as the complexity and unreliability of the procedure, and costs of the materials used [4][5][6][7][8]. In this study, we report a simple and precise technique of AGV tube insertion into the ciliary sulcus using inexpensive 4-0 nylon thread as a guide.…”

Section: Introductionmentioning

confidence: 99%

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A New Technique Using a 4-0 Nylon Thread as a Guide for Easy and Precise Tube Insertion of Ahmed Glaucoma Valve Implant Into Ciliary Sulcus

Nitta¹,

Akiyama²

2023

Cureus

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We present a new technique for inserting the tube of the Ahmed glaucoma valve (AGV) (model FP7; Rancho Cucamonga, CA: New World Medical) implant into the ciliary sulcus, easily and precisely, using a 4-0 nylon thread as a guide. An 88-year-old woman received AGV implantation for secondary angle recession glaucoma with underlying pseudoexfoliation syndrome in her left eye. She had a history of trauma with mild intraocular lens (IOL) oscillation and poor mydriasis, with maximum pupil diameter of 3.5 mm. Ciliary sulcus tube insertion in such patients sometimes becomes difficult, however, using a 4-0 nylon thread as a guide, precise insertion was achieved easily in the following way. A 4-0 nylon thread was placed into the anterior chamber through a 1 mm incision opposite the site of the AGV implant. Subsequently, a 23G needle was inserted into the sclera 2 mm from the corneal limbus in the same quadrant as AGV implants. The tip of the 23G needle proceeded horizontally to the iris, through the sclera and ciliary body, and into the ciliary sulcus. At the center of the pupil, the 4-0 nylon thread was introduced into the lumen of the 23G needle. Subsequently, the 23G needle, together with the 4-0 nylon thread in the lumen was withdrawn out of the eye. The 4-0 nylon was then inserted into the tube lumen of the AGV implant. Finally, by using 4-0 nylon as a guide, the Ahmed tube was inserted into the ciliary sulcus precisely without much difficulty.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A New Technique Using a 4-0 Nylon Thread as a Guide for Easy and Precise Tube Insertion of Ahmed Glaucoma Valve Implant Into Ciliary Sulcus

Nitta¹,

Akiyama²

2023

Cureus

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“…Even though, the use of a 21G needle (outer diameter of 0.81 mm) for the ab interno tube insertion is wider than a 23G needle (outer diameter 0.64 mm) which is commonly used by other authors, it appears to be safe and may not necessarily imply a higher risk. 9,12,15,19…”

Section: Discussionmentioning

confidence: 99%

Needle guided ab interno technique for tube insertion through the ciliary sulcus in uncontrolled glaucoma

Loayza-Gamboa¹,

Martel-Ramirez

Inga-Condezo

et al. 2021

European Journal of Ophthalmology

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Purpose: To describe a modified ab interno technique for the tube implantation from a glaucoma draining device into the ciliary sulcus. Materials and methods: The modified ab interno technique was performed on four eyes of four patients. Results: After the plate was fixed, a 21G needle is inserted through a paracentesis 180° away from the tube position into the anterior chamber and advanced to the posterior chamber through the sclera; finally, the needle exits the eye, then the tube is inserted into the lumen of the needle. The tube is then inserted simultaneously as the 21G needle is pulled out so the tube is placed on the ciliary sulcus. Conclusions: We report a simple and novel technique for the tube implantation from a glaucoma draining device into the ciliary sulcus, in which the tube is guided with a 21G needle from an accessory paracentesis in order to achieve a posterior placement of the tube.

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“…The current technique is easy to perform; the tube is inserted adequately behind the iris but remains visible through the pupil and is a safe distance from the cornea. We have performed other surgical approaches to insert the tube into the posterior chamber, but in our hands, the current technique is the simplest of all the approaches to achieve that end [6]. Our surgical procedure has other potential advantages in that it can be performed with different GDDs with a 23gauge tube (Ahmed or Baerveldt), it can be performed simultaneously with cataract surgery or penetrating keratoplasty or Descemet membrane endothelial keratoplasty (DMEK), or to change the tube from the anterior to the posterior chamber in cases with rapid endothelial cell loss.…”

Section: Discussionmentioning

confidence: 99%

Ab interno implantation of glaucoma drainage devices tubes in the posterior chamber

Moreno-Montañés

Guirao-Navarro

Argüeso³

2020

BMC Ophthalmol

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Background: Glaucoma drainage device (GDD) implantation in the anterior chamber are associated with corneal complications. We describe a novel technique to implant GDD tubes in the posterior chamber of pseudophakic eyes. Methods: Ten patients with glaucoma who required GDD tube implantation were included. Results: The new technique begins with the passage of one of two straight needles existing at each end of a 10-0 Polypropylene suture through the GDD tube. A 23-gauge needle then is inserted at an angle 180°away and passed from the anterior to the posterior chamber and finally through the sclera. The two suture straight needles from the 10-0 Polypropylene suture are positioned in the lumen of the 23-gauge needle. The 23-gauge needle is then extracted from the eye by passing the 2 needles through the lumen. The suture remains inside the posterior chamber, and the tube is inserted into the posterior chamber by pulling on the suture from the other side. No intra-operative complications were found such as bleeding, vitreous tube placement, bent tubes, etc. Conclusions: This surgical procedure to implant a tube into the posterior chamber of the pseudophakic eyes is uncomplicated and facilitates the insertion of the flexible tube into the posterior chamber. This eliminates the tendency of the tube to enter the vitreous as the tube is always placed in the posterior chamber away from the cornea.

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Polypropylene suture–guided valve tube for posterior chamber implantation in patients with pseudophakic glaucoma

Cited by 5 publications

References 13 publications

A New Technique Using a 4-0 Nylon Thread as a Guide for Easy and Precise Tube Insertion of Ahmed Glaucoma Valve Implant Into Ciliary Sulcus

A New Technique Using a 4-0 Nylon Thread as a Guide for Easy and Precise Tube Insertion of Ahmed Glaucoma Valve Implant Into Ciliary Sulcus

Needle guided ab interno technique for tube insertion through the ciliary sulcus in uncontrolled glaucoma

Ab interno implantation of glaucoma drainage devices tubes in the posterior chamber

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