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. 2021 Jan-Apr;15(1):44-46.
doi: 10.5005/jp-journals-10078-1292.

Tube-in-tube: A Solution for Retracted Tube

Surinder S Pandav  1 , Natasha Gautam  1 , Faisal Thattaruthody  1
Affiliations

Tube-in-tube: A Solution for Retracted Tube

Surinder S Pandav et al. J Curr Glaucoma Pract. 2021 Jan-Apr.

Abstract

Tube retraction after Ahmed glaucoma valve (AGV) implantation is an infrequent but known complication. The management option includes the use of a commercially available AGV tube extender, 22 G angiocatheter, resisting the existing glaucoma drainage device (GDD), or insertion of a new GDD. Each of the methods described in the literature has its limitations. We describe the successful management of this complication by using a cost-effective technique of connecting the silicone tube segment to the existing tube to lengthen the tube, so that it could be inserted in the anterior chamber again. The silicone tubes used for the technique were the extra length of the GDD tube, which was cut short and leftover during other GDD implantation surgeries.

Clinical significance: During any GDD implantation, the tube is cut short before entering the anterior chamber. We retrieved the short segments of the tube immediately after the GDD was opened on the table and sterilized them again using plasma technology, available in our operating room. Hence, it provides a cost-effective alternative since the tube is usually trimmed to the desired length in all cases of GDD implantation (valved/non-valved), which can be subsequently sterilized and reused for lengthening the short tube in cases with tube retraction or inadvertently cut tube.

How to cite this article: Pandav SS, Gautam N, Thattaruthody F. Tube-in-tube: A Solution for Retracted Tube. J Curr Glaucoma Pract 2021;15(1):44-46.

Keywords: Glaucoma drainage device complication; Glaucoma drainage implants; Glaucoma drainage surgery; Intraocular pressure; Postoperative complications; Surgical technique; Tube extension; Tube retraction.

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Conflict of interest statement

Source of support: Nil Conflict of interest: None

Figures

Figs 1A to H
Figs 1A to H
(A) The AGV tube identified and mobilized; (B) The lumen of the AGV tube was stretched using Kelman–McPherson forceps; (C) The sterile silicone tube was used for tube extension; (D) The silicone tube was inserted into the AGV tube using McPherson forceps; (E) The inserted silicone tube was secured with McPherson forceps, while the first forceps were cautiously removed from the AGV tube; (F and G) The joint of two tubes was secured by a 10-0 nylon suture; (H) The intraoperative image at the end of surgery showing the visible tube in the anterior chamber
Figs 2A to C
Figs 2A to C
(A) The preoperative anterior segment photograph showing retraction of AGV tube; (B) The postoperative retroillumination anterior segment photograph at a 2-year follow-up with visible tube end in the anterior chamber; (C) The ultrasound showing a well-formed aqueous lake at a 2-year follow-up
See this image and copyright information in PMC

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