Glaucoma Tube Shunt Revision with Scleral "Turtle-Plast"

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Ocular Surface Reconstruction

Background:

• Glaucoma drainage devices are crucial for intraocular pressure management.
• Tube shunt removal or revision can lead to corneoscleral fistulas.
• Securing these fistulas is vital to prevent hypotony and maintain surgical success.

Observation:

• The study presents two cases of glaucoma tube shunt revision.
• A novel technique, the scleral "Turtle-Plast", was employed using Tutoplast grafts.
• The graft was strategically shaped to plug the fistula and reinforce scleral thinning.

Findings:

• The "Turtle-Plast" technique creates a watertight, astigmatically neutral seal for anterior fistulas.
• The graft effectively reinforces adjacent scleral areas susceptible to thinning.
• This method offers an advantage over direct suturing of the tube track.

Implications:

• The scleral "Turtle-Plast" technique provides a reliable solution for managing corneoscleral fistulas post-tube shunt surgery.
• This approach may reduce complications associated with tube shunt revision.
• It offers a valuable alternative for complex glaucoma surgeries requiring shunt revision or removal.