Refractory glaucoma is where IOP cannot be brought under control despite maximal medical therapy and conventional surgical techniques such as trabeculectomy. Glaucoma drainage devices (GDD) such as the Ahmed valve, Molteno, Baerveldt divert aqueous from anterior chamber to an external reservoir. They are useful in cases such as uveitic glaucoma, neovascular glaucoma, glaucoma after keratoplasty and VR surgery, conjunctival scarring from previous surgeries. In this video we show you the step by step implantation of an Ahmed glaucoma valve in two eyes, one post keratoplasty and one post VR surgery.
We often encounter iris defects in our practice which can be secondary to trauma or sometimes iatrogenic. This can cause symptoms to the patient such as glare and diplopia. Single pass four throw pupilloplasty (SFT) is a technique of iris repair and reconstruction, that requires only a single pass, uses the rail road technique, and creates a helical loop configuration that is self-retaining and self-locking. SFT can also be used in fixed dilated pupil post-surgery. It has also been found beneficial in patients with angle closure glaucoma with synechiae where SFT pulls the peripheral iris away from the angle, breaks the synechiae and enhances aqueous outflow. It can also be used in patients undergoing glued IOL to prevent optic capture, and in patients undergoing PDEK for retention of air bubble in the anterior chamber. This video takes you through the surgical steps of performing an SFT.
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