Intraluminal aspiration for Ahmed glaucoma valve tube obstruction

To describe a minimally invasive technique for managing intraluminal obstruction of an Ahmed glaucoma valve (AGV) tube using direct aspiration via the anterior chamber.

A 75-year-old man with AGV implantation for bilateral secondary glaucoma associated with chronic uveitis developed postoperative intraocular pressure (IOP) elevation in his left eye. Although incarceration at the tube tip was released with neodymium-doped yttrium aluminum garnet (Nd:YAG) laser treatment, IOP remained elevated. Anterior segment optical coherence tomography (AS-OCT) revealed tissue-like material within the tube lumen, confirming the diagnosis of intraluminal obstruction. A 30-gauge needle connected to a syringe was inserted into the tube lumen via the anterior chamber, and negative pressure was applied to aspirate and remove the obstructive tissue. IOP normalized promptly after the procedure, and postoperative AS-OCT confirmed disappearance of the occluding material with no recurrence during 1 year of follow-up.

Intraluminal aspiration via the anterior chamber may represent a minimally invasive therapeutic option for AGV tube obstruction that avoids conjunctival incision while preserving bleb function. AS-OCT may play a key role in identifying intraluminal obstruction and determining the indication for surgical intervention.