Precise Placement Of Ahmed Valve Tube In The Sulcus. Comparison Between Two Novel Techniques

 Precise placement of the Ahmed valve tube in the sulcus is critical to ensuring optimal efficacy and reducing complications related to loss of the corneal endothelium. This study introduces and evaluates two novel, minimally invasive techniques to accurately position the Ahmed valve tube in the sulcus. 

zagazig university hospitals

 In the first technique, a 10-0 Prolene suture is utilized.10 mm posterior to the limbus, the tube is trimmed to the appropriate length. A 25-gauge needle is inserted 3 mm posterior to the limbus to enter the sulcus. A 10-0 Prolene suture needle is then passed through a side port into the lumen of the 25- gauge needle, allowing it to exit through the scleral canal. This suture is then secured through the terminal end  tube, where a flange is created using cautery to prevent slippage. The tube is guided through the scleral track into the sulcus before the suture is released.In the second technique, the 10-0 Prolene needle itself serves as a guide wire, assisting in the precise placement of the tube within the sulcus. 

 Both techniques proved to be effective, safe, and relatively easy to perform, ensuring precise placement of the Ahmed valve tube in the sulcus. No significant complications were observed during these procedures. 

 These two novel techniques provide reliable and reproducible methods for the precise placement of the Ahmed valve tube in the sulcus, potentially improving surgical outcomes in glaucoma patients requiring Ahmed valve implantation. Further studies with larger samples may reinforce these initial findings and establish these techniques as standard practice