LAUSR

PRECIS Malposition of the tube through the ciliary sulcus is more frequently observed with the Ahmed valve than the Baerveldt implant due to the weaker rigidity of the Ahmed tube. PURPOSE To report intraoperative and early postoperative complications of ciliary sulcus tube insertion of glaucoma drainage implants (GDIs). PATIENTS AND METHODS We performed retrospective analysis of 104 eyes of 94 patients with GDI tube insertion through the ciliary sulcus were performed. The rigidities of tubes were also examined using a microcompression tester. RESULTS The mean observation period was 20.0 (range, 6 to 60) months. Thirteen eyes were treated with the Baerveldt implant (BDI) and 91 were with the Ahmed valve (AGV). The mean age of the patients was 69.3 (34 to 90) years. The mean IOP was 27.9▒mmHg before surgery and 12.9▒mmHg after surgery (P<0.01). Upon tube insertion 42/91 eyes (46%) with the AGV required reinsertion of the tube due to malpositioning, whereas only 1/13 (8%) eyes with BDI did (P<0.01). Transient hyphema (12 eyes) and hypotony (12 eyes) were observed as early postoperative complications with the AGV. Seven eyes with hypotony were treated by proline stenting of the tube. We could not accomplish sulcus insertions in four eyes. Microcompression analysis of the tubes showed that the BGI tube was more rigid than that of the AGV. CONCLUSIONS Ciliary sulcus insertion of the tube is an effective method to control IOP. The tube of the AGV was more difficult to insert through the sulcus than the BDI due to its weaker rigidity.