A modification of the use of the glaucoma tamponade shell

Filtering surgery may be complicated by excessive filtration or bleb leak in the postoperative period, resulting in a shallow or flat anterior chamber and choroidal detachment. A glaucoma tamponade shell with a raised inner platform increases the resistance to flow through the fistula, deepening the anterior chamber. Some surgeons apply a pressure patch over the shell to increase the tamponading effect and to prevent rotation of the shell. Nevertheless, the shell may still rotate, resulting in less than adequate tamponade. We describe a technique that prevents rotation of the shell.