New surgical technique for correcting tube-iris touch following glaucoma drainage implant surgery

Glaucoma drainage implant surgery may be associated with a number of potential complications including tube malpositioning. This malpositioning may have serious sequelae such as corneal endothelial damage, chronic iritis, cataract formation or tube occlusion. Traditional management of tube malpositioning involves major surgical re-dissection and reinsertion of the tube. Alternatively, shortening of the tube within the anterior chamber can, in some circumstances, relieve tube contact with the endothelium or iris. However, these procedures are associated with important risks. We describe a new minimally invasive surgical technique for correcting posterior tube malpositioning that avoids the need to shorten the tube or re-dissect the conjunctiva. This technique is straightforward to perform and has successfully maintained proper drainage device tube position during more than 1 year of follow up.