Scleral tunnel for the implantation of glaucoma seton devices

The technique described in this paper shows how to use a long scleral tunnel for the implantation of anterior tube parts of glaucoma drainage devices. It involves the creation of a scleral tunnel beginning 10 mm behind the limbus and extending to the anterior chamber. Anterior tube parts of Krupin eye valve with disk is inserted through the scleral tunnel to the anterior chamber. The disk part is secured to the episclera as used in the standard technique. We have used this technique in 6 eyes of 6 consecutive patients with refractory glaucoma. The placement of anterior tubes as part of glaucoma seton devices was done in all patients. While mean intraocular pressure (IOP) was 39.3 +/- 4.9 mm Hg (ranged from 29 to 56 mm Hg) preoperatively, it was 16.6 +/- 5.3 mm Hg (ranging from 11 to 25 mm Hg) at the end of follow up. Mean follow-up time was 7.16 +/- 1.16 months (ranging from 6 to 9 months). After surgery, conjunctival erosion or displacement of the anterior tube and dellen formation were not found in any eyes. The use of a long scleral tunnel for the implantation of anterior tube parts of glaucoma seton devices offers some advantages over standard implantation techniques.