J Korean Ophthalmol Soc.  2017 Jul;58(7):879-884. 10.3341/jkos.2017.58.7.879.

Tube Erosion with Scleral Melting after Ahmed Valve Implantation Using a Synthetic Dural Substitute

• Ahn HM
• Park JW

• KMID: 2387166
• DOI: http://doi.org/10.3341/jkos.2017.58.7.879

Abstract

PURPOSE
The objective of this case report was to present tube erosion of Ahmed valve implantation using a synthetic dura substitute (Neuro-Patch®, B. Braun, Boulogne, France).
CASE SUMMARY
Tube erosion was caused by dissolution of the conjunctiva and partial-thickness scleral tunnel in 5 patients who received Ahmed valve implantation using a synthetic dura substitute for glaucoma treatment 2 to 4 months after the operation. Furthermore, the patients required re-operation for preventing secondary complications such as endophthalmitis.
CONCLUSIONS
This case series using a synthetic dura substitute in Ahmed valve implantation demonstrated the risk of tube erosion with scleral tunnel melting and following secondary complications even with a partial-thickness scleral tunnel method.

Keyword

Ahmed valve complication; Neuro-patch; Synthetic dura; Tube erosion

MeSH Terms

Conjunctiva
Endophthalmitis
Freezing*
Glaucoma
Humans
Methods

Figure

• 

  Figure 1 Image of Neuro-patch® (B. Braun, Boulogne, France). 3 × 3 mm Neuro-patchy was placed on scleral flap and covered with conjunctival flap.

• 

  Figure 2 Images of tube erosions with scleral melting in Ahmed valve implantation using a synthetic dura substitute (case 4). (A) One month after the operation, synthetic dura substitute was shown through the thinning conjunctival in the left eye. (B) The conjunctival thinning was aggravated for 2 weeks. (C) 3 months after the operation, Ahmed valve tube was exposed with melting sclera and conjunctiva and synthetic dura substitute was difficult to be recognized from the original shape. (D) Ahmed valve revision was performed with collagen glycoaminoglycan substitute.

• 

  Figure 3 Four months after Ahmed valve implantation using a synthetic dura substitute in case 3. (A) Ahmed valve tube was exposed with conjunctival buttonhole in the left eye. (B) Ahmed valve body was exposed through the conjunctival buttonhole in right eye.

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