Purpose: To describe a new technique of Ahmed glaucoma valve implantation in patients with refractory glaucoma and present the long-term results.
Methods: Twenty-eight eyes of 28 patients with refractory glaucoma participated in the study. "Double scleral tunnel in tandem" technique was used for glaucoma valve implantation in all patients. The technique consists of the formation of two scleral tunnels in tandem so as to completely cover the extraocular part of valve's tube and facilitate a parallel to the iris placement of the intraocular part of the tube.
Results: Postoperative hypotony developed in two (7.1%) cases which resolved within 3 days in all cases. One (3.6%) eye manifested postoperative hyphema that resolved without complications within a week, and two (7.1%) cases presented with exposure of the tube. The average highest postoperative intraocular pressure (IOP) during the follow-up period was 19 mmHg (range 8-38 mmHg) without medications, and the average IOP at the last follow-up visit was 14.5 mmHg (range 8-22 mmHg). Additional treatment for IOP control was necessary in 11 (39.3%) cases. The average follow-up period was 60 months.
Conclusion: This novel technique was found to be easy to master, effective and with low cost and rate of complications.
Keywords: Double scleral tunnel in tandem; Glaucoma valve; Glaucoma valve implantation technique; Tube exposure.