Procedures
Glaucoma Consultants provides a comprehensive array of surgeries, treatments and procedures for both glaucoma and cataracts. To find out more details on any of these procedures, click on the links below.

SURGERIES:
• Glaucoma Drainage Device (Tube Shunt/Ahmed Valve)

Glaucoma drainage devices, also known as tube shunts, or Ahmed Valves, are implanted devices that are designed to maintain an artificial drainage pathway for patients with glaucoma. This procedure is often chosen for patients at high risk of failure with a traditional glaucoma filter procedure (trabeculectomy). Such patients might include those with neovascular glaucoma, glaucoma associated with uveitis (iritis), prior history of failure with a filter procedure, and any patient with glaucoma under 30 years of age. All of these patients are at significant risk for failure of a routine glaucoma filter procedure due to greater inflammation and fibrosis (scarring), which might close off the drainage canal. The Procedure:
Prior to surgery, your ophthalmologist will have you take eye drop medications to prepare your eye for surgery. These may be begun on the day of the surgery, or even up to 3 days prior to surgery. Just prior to surgery local anesthesia will typically be given to numb you eye for surgery. In young children, the procedure must be performed under general anesthesia.

A small incision is made in the conjunctiva, usually toward the top of the eye, however, the surgery may be performed in other quadrants of the eye. The surgeon will then make a tiny incision in the sclera of the eye and will fashion an opening for the drainage implant device. The drainage tube will be placed such that the opening of the tiny tube is inside the anterior chamber of the eye where it is bathed in aqueous fluid. The tube is sutured in place with the drainage device attached to the sclera of the eye. Once the tube shunt is securely sutured into the desired position, the conjunctiva over the device is closed with tiny sutures, which are considerably finer than human hair. (top of page)

After Your Operation:
You will be instructed to use antibiotics, anti-inflammatory medicines, and probably glaucoma medications following the procedure. The actual medicines and dosing schedules will be carefully planned and reviewed with you by your eye surgeon and his staff. You may expect to use these additional medicines for up to two or three months after surgery to help prevent infection and control inflammation.

In general, you will likely be able to return to most activities within a day or two after surgery. Your eye may feel scratchy or have a foreign body sensation. This should usually resolve in the first one to two weeks. Your surgeon will instruct you as to strenuous activities.

See our Frequently Asked Questions

Will my Glaucoma Be cured with the Tube Shunt Device?
In general, glaucoma cannot be reversed. The damage which has ensued prior to surgery is essentially irreversible, since the optic nerve does not regenerate. The best result that can be expected is a complete halt of the progression of glaucoma. This can only be known by following visual signs of the optic nerve and evaluating peripheral vision with visual field testing.

What are the Risks with a Tube Shunt Device?
The risks of this procedure include, but are not limited to, over-filtration (pressure too low in the eye), under-filtration (pressure remains too high in the eye), infection, bleeding, swelling of the retina, fluid under the retina (choroidal detachment), droopy eyelid, double vision, loss of vision and even loss of the eye. In general, however, if your surgeon recommends a tube shunt implantation, he or she believes the benefits of the procedure far outweigh the potential risks.

Will I Still Need Medication After a Tube Shunt?
All patients will need eye drop medications to help prevent infection and inflammation after a tube shunt implantation, usually for the first two to three months. After that, use of glaucoma medications to further control pressures will depend on the outcome of the surgery, i.e., the pressure in the eye.

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