Secondary stenting of glaucoma drainage implant: a novel technique for treatment of late hypotony

A modified technique for intraluminal stenting of glaucoma drainage devices: The guide-wire technique

“…In addition, we have previously performed ab-interno retrograde insertion of 3–0 Supramid suture into the internal os of a Baerveldt tube to successfully control hypotony. [ 4 ] The initial indication for implant insertion in these cases was uncontrollable uveitic glaucoma and uncontrollable glaucoma in a patient with chronic iridocyclitis. [ 4 ] In these cases, a short segment of Supramid suture was passed across the anterior chamber and fed up the tube using micro forceps.…”

“…[ 4 ] The initial indication for implant insertion in these cases was uncontrollable uveitic glaucoma and uncontrollable glaucoma in a patient with chronic iridocyclitis. [ 4 ] In these cases, a short segment of Supramid suture was passed across the anterior chamber and fed up the tube using micro forceps. [ 4 ] We have found this to be an effective way of managing postoperative hypotony with glaucoma tubes.…”

“…[ 4 ] In these cases, a short segment of Supramid suture was passed across the anterior chamber and fed up the tube using micro forceps. [ 4 ] We have found this to be an effective way of managing postoperative hypotony with glaucoma tubes. Our favorable experience with this maneuver, and our results from this case series, suggest that stenting the internal os of glaucoma drainage tubes reduces aqueous drainage.…”

Ab interno tube ligation for refractory hypotony following non-valved glaucoma drainage device implantation

“…A recent case report describes the ab interno placement of two 5/0 nylon sutures to stent an Ahmed glaucoma valve without the need for intracameral tube tying in an eye with neovascular glaucoma [12], with good 6-month outcomes. Another paper describes the use of a 3/0 Supramid suture inserted ab interno for two cases of persistent hypotony, but with limited long-term data [13], whilst another study describes ab externo insertion of the Xen gel stent into the GDD tube lumen of two cases with chronic hypotony [14]. However, these techniques alone may not always resolve hypotony, particularly in very high-risk cases with volatile aqueous production rates [15].…”

Commentary: Intraluminal stenting of non-flow restrictive glaucoma drainage devices

“…[ 1 ] Persistent hypotony would need surgical intervention; several methods that have been tried include religature to the tube, stenting of the tube with 3-0 Nylon, Prolene, or Supramid sutures. [ 3 4 5 6 ]…”