Glaucoma drainage tube kink after pars plana insertion

To describe focal obstruction of drainage tubes by kinking at the scleral entry site after pars plana insertion.

Case study.

Three eyes of three patients underwent uncomplicated placement of a Baerveldt implant into the vitreous cavity at the time of pars plana vitrectomy. Intraocular pressure remained increased after the procedure without evidence of flow. Surgical exploration and modification of the tube placement resulted in immediate intraocular pressure reduction. Compression of the tube at the scleral entry site was confirmed intraoperatively in all eyes by ultrasound biomicroscopy.

Kinking of the tube at its scleral entry site should be recognized as a possible cause of increased intraocular pressure without bleb formation after pars plana insertion of a glaucoma drainage implant.