Uveal prolapse 3 months s/p Ahmed Glaucoma Valve revision

Uveal prolapse at surgical margin Ahmed GV

Rather unexpectedly, this 78 year old gentleman showed up for a follow-up visit, almost three months since surgery, with uveal tissue prolapsing out his suture line. The slit lamp photo is from today's visit.

HIs original Ahmed Glaucoma Valve surgery too place more than 2 years prior for herpes associated uveitic glaucoma. More recently, after a round of posterior sub-tenons injections for macular edema, he was referred back to me for hypotony and then over the course of the month that followed, his sutures from his donor scleral graft eroded through the conjunctiva and I performed a surgical revision including re-grafting donor sclera. After finally getting some massive inflammation under control requiring copious amounts of topical prednisolone acetate and bumping up his Valtrex to 1000mg TID for a few weeks, he presented today with uveal prolapse and now awaits urgent repeat surgery.