[Glaucoma drainage devices in patients following injector-assisted implantation of an artificial iris into the ciliary sulcus : Video article].

Abstract

Objective of surgery: The aim of this surgical technique is the implantation of a glaucoma drainage device (GDD) in eyes with aphakic glaucoma following injector-assisted implantation of an artificial iris into the ciliary sulcus.

Indications: This atraumatic tube insertion technique can be performed during GDD implantation after implantation of an artificial iris into the ciliary sulcus.

Surgical technique: Following injector-assisted implantation of an artificial iris into the ciliary sulcus of eyes, the iris can shift into the chamber angle. The GDD should be positioned in the quadrant in which the iridectomy is located. Otherwise, GDD implantation is not possible due to the resistance of the artificial iris. Alternatively, the artificial iris can be easily and non-traumatically rotated in the ciliary sulcus by flushing the anterior chamber with balanced salt solution (BSS) to move the iridectomy into the desired area and position the GDD tube in the anterior chamber. A surgical video, which is available online, shows the surgical technique in detail.

Follow-up: After GDD, dexamethasone eye drops should be applied 8 times daily for 1 week tapering down by 1 drop per week thereafter. Antibiotic eye drops, e.g., ofloxacin eye drops, are prescribed 4 times daily for 1 week and might be discontinued thereafter.

Evidence: To date, this is the first description of a rotation of an artificial iris located in the ciliary sulcus by irrigation of the anterior chamber during GDD implantation.