Complex Case: PK, Glued IOL, and Ahmed Valve Implantation

In this video from Dr. Osher's Video Journal of Cataract and Refractive Surgery, Dr. Amar Agarwal describes a 61-year-old diabetic man with a corneal ulcer and multiple previous ocular surgeries that include penetrating keratoplasty (PK), trabeculectomy, and extracapsular cataract extraction (ECCE).

The patient presents with inferior graft melt, exposed lens haptics, and a flat anterior chamber. The surgeon removes the old corneal graft, explants the existing IOL and replaces it with a glued 3-piece IOL, and implants an Ahmed glaucoma valve. The pupil is reconstructed and the donor button is sutured in place. At the conclusion of the case, the cornea appears clear, the IOL is well centered, and the tube tip sits properly behind the lens.