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Glaucoma Surgery; How to manage the failing tube
Author(s) -
Besinis Dimitrios
Publication year - 2019
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2019.8108
Subject(s) - medicine , glaucoma , glaucoma valve , trabeculectomy , intraocular pressure , surgery , shunt (medical) , glaucoma surgery , neovascular glaucoma , ophthalmology , diabetic retinopathy , diabetes mellitus , endocrinology
Glaucoma drainage devices ( GDD s) have been commonly used for refractory glaucoma as the last resort of managing the progression after a failed trabeculectomy. However there are certain types of glaucoma, where a primary tube is more effective in IOP control, like neovascular glaucoma and anterior segment dysgenesies. The two most commonly used tubes are the Ahmed valve and the Baerveldt shunt. Even though both of them are effective in giving adequate control of IOP , there are cases where the pressure begins to rise and the tube starts to fail. Tube failure can happen in either the early postoperative period or as a late complication. Mangement of the hypertensive phase and tube failure is different between the devices because of the different mechanism of action. In this talk I will present the management of failure of Ahmed and Baerveldt tubes and the next step in the treatment strategy.