Purpose: To introduce a new technique of short tunnel small flap graft-free glaucoma drainage device implantation and report our early experience. Methods: In a retrospective study, patients with uncontrolled primary open-angle glaucoma underwent short tunnel small flap graft-free Ahmed glaucoma valve implantation. In this technique, plate is sutured 8–10 mm posterior to the limbus and a partial thickness flap is made at 1 or 11 o’clock position, 1 mm posterior the limbus. Tube was passed through a tunnel immediately anterior to the plate into the proximal edge of the flap and then inserted into the anterior chamber via a route underneath the flap. Flap then covered the distal end of the tube and conjunctiva was sutured. Patients were followed for a minimum of 12 months for any sign of tube exposure and rise of intraocular pressure. Results: A total of 16 consecutive patients with refractory primary open-angle glaucoma and uncontrolled intraocular pressure were included in this study. Mean age of participants was 59 ± 8.3 years and nine (56%) were male. Mean intraocular pressure at the time of presentation was 26 ± 6.2 mm Hg, which dropped to 16 ± 4.5 at 12 months postoperative follow-up. The number of medications at baseline was 3 ± 1 eye drops, which was decreased to 1 ± 1.2 at 12 months. There were no conjunctival and flap-related complications or any sign of tube exposure during 1-year postoperative period. Conclusion: Short tunnel small flap graft-free glaucoma drainage device implantation technique combines advantages of both tunneling and flap techniques. Also, it may result in better tube positioning and more favorable cosmetic outcomes.
Relationship between Glaucoma Drainage Device Size and Intraocular Pressure Control: Does Size Matter?
