Suture stent insertion into an over draining tube shunt lumen via single paracentesis

Glaucoma tube shunts, especially Baerveldt-350s, carry the risk of hypotony-associated complications. In a 2016 letter to the editor by Kuruvilla et al., a technique was described to secondarily stent Baerveldt tube lumen with 3-0 Supramid suture to minimize hypotony-associated complications. Others have further described or demonstrated this technique, which uses two paracenteses, in surgical videos. This case report demonstrates our adaptation of the aforementioned technique to insert a suture stent into an over-draining tube shunt via a single paracentesis. We also describe a case of a patient with severe primary angle glaucoma and a Baerveldt-350 who developed late hypotony with maculopathy and a decline in visual acuity. With this technique, her intraocular pressure rose, maculopathy resolved, and visual acuity improved.