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Glaucoma drainage tube kink after pars plana insertion
R F Rothman1, P A Sidoti, R C Gentile
1Department of Ophthalmology, The New York Eye and Ear Infirmary, 310 East 14th St., New York, NY 10003, USA.
American Journal of Ophthalmology
|September 1, 2001
Summary
Kinking of glaucoma drainage tubes at the scleral entry site can cause increased intraocular pressure after pars plana insertion. This obstruction, confirmed by ultrasound biomicroscopy, requires surgical correction for effective intraocular pressure reduction.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Biomedical Engineering
Background:
- Pars plana insertion of glaucoma drainage implants is a common surgical procedure.
- Effective drainage is crucial for managing intraocular pressure in glaucoma patients.
Observation:
- Three patients experienced persistent high intraocular pressure post-Baerveldt implant surgery.
- Ultrasound biomicroscopy revealed tube kinking at the scleral entry site as the cause of obstruction.
Findings:
- Baerveldt implants placed via pars plana can kink at the scleral entry site.
- This kinking obstructs tube flow, leading to elevated intraocular pressure and absence of a bleb.
- Surgical revision of tube placement resolved the obstruction and reduced intraocular pressure.
Implications:
- Recognizing tube kinking is essential for diagnosing post-operative IOP elevation after pars plana glaucoma drainage implant surgery.
- Proper surgical technique and intraoperative assessment are vital to prevent or identify tube kinking.
- This finding may inform the design and implantation techniques for glaucoma drainage devices.