Related Experiment Video
Updated: Aug 6, 2026

Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
[Bubble mirror technique for express shunt surgery]
J Marín-Montiel1, E López-Sánchez1, V Chaqués-Alepuz2
1Servicio de Oftalmología, Hospital Universitario Arnau de Vilanova, Valencia, España; Facultad de Medicina, Universidad Católica de Valencia San Vicente Mártir, Valencia, España.
Surgical Technique:
The bubble mirror technique consists of the stabilization of the anterior chamber by means of a plug made with a combination of conveniently placed air and viscoelastic material. A line arises at interface between the air and viscoelastic where the anterior chamber angle reflected can be seen as in a mirror (bubble mirror).
Discussion:
The viscoelastic-air plug offers three advantages in glaucoma surgery with the Ex-PRESS implant: 1) plug effect of viscoelastic, giving stability to the anterior chamber and preventing it from collapsing; 2) toning effect of the air bubble; and 3) specular effect at the interface, which allows the surgeon to visually control the chamber angle during the Ex-PRESS implantation.

