Graft-Free Glaucoma Drainage Device Implantation

This video presents a new short tunnel, small flap (STSF) technique for improved, graft-free glaucoma drainage device implantation. In this surgery, a patient with primary open-angle glaucoma was treated for cataracts and uncontrolled IOP. After the Ahmed glaucoma valve was secured, physicians cut a 2.5 x 2.5-mm thick flap, 1 mm posterior to the limbus. They shortened the tube to 2 mm. A tunnel, made using a 23-gauge needle, enabled the tube to be redirected from the anterior boarder of the sclera bed to the anterior chamber. The flap, conjunctiva and tenons were all secured using sutures. Fusing the tunnel and flap techniques, STSF minimizes the risk of tube erosion and may improve tube positioning.

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