Using a Finder Needle to Implant a Drainage Device for Pediatric Glaucoma

Drs. Ann Shue and Sharon Freedman present tips for glaucoma drainage device implantation tube insertion in pediatric glaucoma, especially when anatomy may be unusual and finding the ideal sclerostomy site may be difficult. First, use a 30-gauge needle to enter the eye in the desired location and assess if the position is appropriate. If the needle is too anterior or posterior, then the needle can be used again in a different location. Given the small entrance, there is no need to close the sites from the 30-gauge needle, so the usual 23-gauge needle can be used to enter the eye through the most appropriate 30-gauge track. Lightly marking the needles on one side with a stroke of a marking pen helps to identify the sclerostomy entrance for tube insertion. The video also demonstrates tube insertion with this technique in an aniridic patient; here, the tube is placed over the zonules and parallel to the lens in order to reduce the risk of central corneal and lens injuries.

Financial Disclosures: Dr. Ann Shue discloses no financial relationships. Dr. Sharon Freedman discloses financial relationships with National Eye Institute (Grant Support); Qlaris Bio (Consultant/Advisor).