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• W2565794997 abstract "Recently, we experienced a challenging surgical complication we wish to share with the readers. A 49-year-old gentleman underwent a Baerveldt BG 103-250 glaucoma implant (Abbott Laboratories Inc., Abbott Park, IL, USA) for uncontrolled primary open-angle glaucoma on his right eye. On postoperative day one, he presented with a flat anterior chamber, low intraocular pressure (IOP) and choroidal folds. After a few days of conservative measures and no improvement, we decided to intervene. The surgical technique involved the exposure of the tube by opening the original conjunctival flap and removal of the scleral patch graft to ascertain that the original 7-0 vicryl suture made to ligate the tube during the primary implantation of the implant was tight and in place. After placing an additional suture to ligate the tube, we noticed a leak around the tube insertion on the sclera. The scleral site was dried with a sterile cotton tip applicator. A 30-gauge needle was used to apply a few drops of n-butyl-2-cyanoacrylate tissue adhesive to the tube insertion site, and the anterior chamber was filled with viscoelastic substance (Fig. 1). The tube was covered with a patch graft from cadaver sclera secured with four 10-0 nylon sutures. A few weeks after the surgery, the anterior chamber was deep and the IOP controlled with no medication. The choroidal folds had vanished and the vision improved. Cyanoacrylates are synthetic adhesives with very high tensile strength that rapidly polymerize in the presence of water or blood forming long, strong chains that bond surfaces together. They have been used in ophthalmology to treat corneal perforations, in posterior retinal breaks associated with retinal detachments, for attaching conjunctival autografts after pterygium excision and for closure of filtering bleb leaks in patients with glaucoma (Weiss et al. 1983; Zalta & Wieder 1991; Hartnett & Hirose 1998; Uy et al. 2005). As an alternative to cyanoacrylate, fibrin-based adhesives have been previously used in similar situations. Valimaki (2006) reported the use of fibrin glue to prevent a leak of aqueous around the tube in the immediate postoperative period after glaucoma drainage implant. The glue was used intraoperatively over the scleral flap in eyes with leakage around the tube insertion. They report good IOP control and no complication. As compared to biological adhesives, cyanoacrylate is less expensive and could be used as a safe alternative in places where economic issues are a concern." @default.
• W2565794997 created "2017-01-06" @default.
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• W2565794997 date "2016-12-28" @default.
• W2565794997 modified "2023-09-27" @default.
• W2565794997 title "Managing glaucoma drainage device tube leak with cyanoacrylate" @default.
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• W2565794997 doi "https://doi.org/10.1111/aos.13349" @default.
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