J Korean Ophthalmol Soc > Volume 56(5); 2015 > Article
Journal of the Korean Ophthalmological Society 2015;56(5):794-798.
DOI: https://doi.org/10.3341/jkos.2015.56.5.794    Published online May 15, 2015.
A Case of Persistent Shallow Anterior Chamber in Glaucoma Drainage Device Implantation Recovered by Fibrin Glue.
Yoon Jae Wi, Ka Young Lee, Young Cheol Yoo
Department of Ophthalmology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea. demian7435@gmail.com
방수유출장치삽입술 중 실리콘관 삽입 후 지속되는 얕은 전방을 파이브린글루를 사용하여 치유한 1예
위윤재⋅이가영⋅유영철
한림대학교 의과대학 강동성심병원 안과학교실
Abstract
PURPOSE
To report a case of persistent shallow anterior chamber after silicone tube intubation, recovered by fibrin glue in glaucoma drainage device implantation (GDI). CASE SUMMARY: A 42-year-old female, diagnosed with neovascular glaucoma at a local clinic visited our clinic for uncontrolled intraocular pressure (IOP) in her right eye. We performed GDI on her right eye. Scleral flap and paracentesis of the anterior chamber were performed. Then, a silicone tube was inserted into the anterior chamber. Despite repetitive infusion of balanced salt solution (BSS), the anterior chamber became persistently shallow due to peritubular leakage. After dropping the fibrin glue in the peritubular space and beneath the scleral flap, attachment occurred. No additional leakage was observed near the scleral flap and after infusion of BSS, a deep anterior chamber was maintained. One day after surgery, IOP in the right eye was 3 mm Hg, deep anterior chamber was maintained, and no leakage of aqueous humor into the conjunctiva occurred. Two months after surgery, IOP was 16 mm Hg and a deep anterior chamber was maintained. CONCLUSIONS: In cases of persistent shallow anterior chamber after silicone tube intubation in intraoperative GDI, the best methods to maintain the anterior chamber is by suture ligation of the peritubular loosened site or infusion of viscoelastic agent to anterior chamber. In the present case, applying the fibrin glue beneath the scleral flap apparently obstructed the peritubular infiltration.
Key Words: Aqueous leak;Fibrin glue;Glaucoma drainage device implantation;Peritubular infiltration;Silicone tube


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