Uveal prolapse 3 months s/p Ahmed Glaucoma Valve revision

Uveal prolapse 3 months s/p Ahmed Glaucoma Valve revision
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.
 
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Ahmed Glaucoma Valve under scleral tunnel - modified Gdih technique

Ahmed Glaucoma Valve under scleral tunnel - modified Gdih technique

After learning about a modification of the Ahmed Glaucoma Valve implantation for glaucoma that avoids the use of donor material in favour of creating a scleral tunnel, I gave it a try.

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56 y.o. male with advanced Juvenile open angle glaucoma experience worsening of vision

56 y.o. male with advanced Juvenile open angle glaucoma experience worsening of vision
This 56 y.o. male whom I have been following for the past 14 years with Hand Motions visual acuity in both eyes, presented with a two week history of noticing his vision to be even worse than usual and finding himself to be light sensitive. This was not what I was expecting to find.Read More

Suture to pull Ahmed Glaucoma Valve tube tip away from cornea

It is far easier to use a 10-0 mersiline double-ended suture to pull back a tube tip than to perform a major re-operation that would have involved opening the prior surgery site, cutting away extensive scar tissue, lifted up the donor sclera flap, reposition the tube entry site, then closed things up again.

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Tobradex NOT to be used for itchy/burny eyes; they can cause glaucoma!

Tobradex NOT to be used for itchy/burny eyes; they can cause glaucoma!

I was referred a patient as a glaucoma suspect due to high intraocular pressure readings when seen by his referring Optometrist. The eye pressures were fine on the day I saw the patient and I was ready to give him my standard explanation for ocular hypertension being a risk factor for glaucoma but that a high pressure reading does not = glaucoma. As he was about to leave, he pulled out a bottle of Tobradex that he had been prescribed to take whenever his eyes felt gritty! Let’s talk about this one.

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Revising infection prone Trabeculectomy using donor scleral graft

​This patient had undergone a trabeculectomy with mitomycin (MMC) in both eyes more than 4 years ago and has recently been suffering from recurrent bleb leaks and infections. As can often happen, especially with the older approach of the day of limbal-based surgery (conjunctival incision in the fornix) with the MMC applied over a more localized area, the bleb enlarged and thinned over the years.

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