Needle guided ab interno technique for tube insertion through the ciliary sulcus in uncontrolled glaucoma

Abstract

Purpose: To describe a modified ab interno technique for the tube implantation from a glaucoma draining device into the ciliary sulcus. Materials and methods: The modified ab interno technique was performed on four eyes of four patients. Results: After the plate was fixed, a 21G needle is inserted through a paracentesis 180° away from the tube position into the anterior chamber and advanced to the posterior chamber through the sclera; finally, the needle exits the eye, then the tube is inserted into the lumen of the needle. The tube is then inserted simultaneously as the 21G needle is pulled out so the tube is placed on the ciliary sulcus. Conclusions: We report a simple and novel technique for the tube implantation from a glaucoma draining device into the ciliary sulcus, in which the tube is guided with a 21G needle from an accessory paracentesis in order to achieve a posterior placement of the tube.