What Is a Glaucoma Drainage Implant?

Glaucoma drainage implantation is to implant an artificially designed drainage device into the anterior or posterior chamber, and use the diffuser to drain the aqueous humor directly under the conjunctival sac or under the fascia sac. According to whether the catheter has a valve or not, drainage devices are divided into two types: glaucoma drainage devices without valves and glaucoma drainage devices with valves. During the glaucoma drainage implantation, the common used tools are eye speculum, ophthalmic cannula, corneal cannula, ophthalmic forceps, etc.

 

The glaucoma drainage implant is a small device placed in the eye to treat glaucoma. For glaucoma, aqueous humor cannot be drained normally from the eyes. Pressure builds up in the eye, which damages the optic nerve. If without treatment, glaucoma can cause blindness. Drainage implants (also called aqueous diverters or tube shunts) create a new way for aqueous humor to drain from the eye. This helps reduce eye pressure.

 

When eye drops and laser treatment do not sufficiently reduce the eye pressure, your ophthalmologist may recommend drainage implants. There is no treatment that can solve the damage that has already been done to the optic nerve. But drainage implants can help prevent further damage to glaucoma.

 

 

How is the Glaucoma Drainage Implant Surgery Performed?

The glaucoma drainage implant surgery is performed in an outpatient surgery center or a hospital. This process usually takes about an hour or less, and during the process, the possible tools such as suturing forceps, intraocular scissors, corneal scissors, etc, may be used . The surgical steps are:

 

1) Make a conjunctival flap with the fornix as the base between the two muscles in the selected quadrant.

2) Suture the fixing hole of the drainage disc on the superficial sclera.

3) Make a scleral flap covering the silicone tube in the same area of the corneoscleral limbus to protect the drainage tube.

4) Use a No. 7 injection needle to puncture into the anterior chamber at the corner of the sclera under the scleral flap. After exiting, inject a little viscoelastic agent into the anterior chamber, adjust the length of the drainage tube and extend the drainage tube along the incision into the anterior chamber.

5) Suture the superficial scleral flap to prevent the drainage tube from being exposed.

6) Suture the conjunctiva and inject dexamethasone and gentamicin under the conjunctiva.

 

After the surgery, your eyes may have been repaired and you may need to wear the patch overnight. Plan to have someone drive you home after the surgery. Your vision may become blurred after a few days to a few weeks.

 

Your ophthalmologist will prescribe some medicine to take for a few weeks after the operation. These medicine help prevent infection, discomfort and scarring. During the recovery process, do not bend over, tighten or lift heavy objects. Your ophthalmologist will give you specific instructions and tell you when you can perform these work again. Most people with glaucoma drainage implants will need to continue taking glaucoma medications.

 

Complications of glaucoma drainage implant surgery include: expulsion of intraocular hemorrhage, delayed anterior chamber formation, and fibrosis of the filtration channel. Your ophthalmologist will discuss with you the risks and benefits of drainage implants for glaucoma.

 

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