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. 2024 Oct 4;24(1):435.
doi: 10.1186/s12886-024-03694-1.

Use of double short tandem scleral tunnels for repairing eroded ahmed glaucoma valve tubes

Jun Yu  1 , Xiangjun Dai  1 , Xiaohua Chen  1 , Xiaoming Gao  2 , Weihua Pan  3
Affiliations

Use of double short tandem scleral tunnels for repairing eroded ahmed glaucoma valve tubes

Jun Yu et al. BMC Ophthalmol. .

Abstract

Purpose: To evaluate the effectiveness and safety of a method for repairing an eroded Ahmed glaucoma valve (AGV) tube using two short scleral tunnels made in tandem with a 22G needle instead of covering the eroded tube with another scleral graft.

Methods: From May 12, 2015, to July 27, 2019, we retrospectively reviewed eight patients at Ningbo Aier Eye Hospital who developed AGV tube erosion secondary to necrosis of their overlying conjunctiva and scleral grafts. This defect was repaired in all the patients using the double short tandem scleral tunnel technique, which involved the creation of double short tandem scleral tunnels made by a 22G needle. Two parallel-to-limbus scleral incisions were made 3 mm and 6 mm from the limbus first, then a curved 22G needle was inserted between the two scleral cuts to make one scleral tunnel, the other scleral tunnel was completed during the first surgery, inserted the tube into the two tunnels. The mean length of time between the AGV placement and the first erosion was 12.25 ± 6.36 months (3-24 months). The mean age of the patients was 65.50 ± 11.70 years (49-78 years).

Results: The surgical outcome was assessed in terms of the tectonic integrity of the conjunctiva over the follow-up period (12 months). There was no AGV tube erosion, scleral thinning, or ocular infection after a mean of 41.25 ± 26.54 months of follow-up in all eight patients.

Conclusion: AGV tube erosion following shunt surgery can be successfully managed using the improved double short tandem scleral tunnel technique.

Keywords: Ahmed glaucoma valve; Double short tandem scleral tunnels; Tube erosion.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Expose the scleral surface
Fig. 2
Fig. 2
Make a scleral incision 3 mm from the limbus
Fig. 3
Fig. 3
Make a scleral incision 6 mm from the limbus
Fig. 4
Fig. 4
Prepare a curved 22G needle
Fig. 5
Fig. 5
The curved needle is inserted between the distal scleral cut and proximal cut
Fig. 6
Fig. 6
The tube is inserted in to the origin scleral tunnel and then enter the anterior chamber
See this image and copyright information in PMC

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