PMC7327559_01
Summary of the Baerveldt glaucoma implant (BGI) surgery. (a) The implant was slipped between the sclera and Tenon's capsule 10 mm posterior to the limbus and then positioned and securely sutured at superotemporal quadrant. (b) A scleral flap was made for the insertion of the tube, and then, the tube was cut and beveled anteriorly. (c) An opening was made underneath the scleral flap, and the tube was inserted into the anterior chamber. (d) The final position of the tube in the anterior chamber was checked, and scleral flap was sutured, followed by closure of Tenon's capsule and conjunctiva.
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Ana, California, United States) surgery (Figure 1). A 350 mm2 Baerveldt implant was placed in the superotemporal quadrant. A limbus-based conjunctival flap was dissected, and the implant was sutured securely to the sclera.
The final tube position after the initial BGI surgery. The tube was left longer in the anterior chamber just below the inferior pupillary margin.
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Due to the presence of SO, the tube was left longer and lower in the anterior chamber below the inferior edge of the pupil (Figure 2).
The tube was blocked by the iris tissue at the pupillary margin.
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February 2018, the IOP was suddenly elevated to 46 mmHg. From slit lamp examination, the cornea remained clear and there was no tube-corneal touch, but unfortunately, the tube was blocked by the iris tissue (Figure 3).
The tube trimming technique. (a) A single paracentesis was made approximately 1 clock hour temporally from the tube insertion. (b) Viscoelastic was injected to release the iris tissue blockage from the tip. (c) Through the paracentesis, the tube was pulled out from the anterior chamber using forceps. (d) The tube tip was held steady with forceps and transected with scissors. (e) Then, the tube was inserted back into the anterior chamber.
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Tube trimming was immediately performed efficiently with a relatively easy technique (Figure 4).