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Photo Essay |

Transcorneal Tube Erosion of an Ahmed Valve Implant in a Child

Abdullah Al-Torbak, MD, FRCS; Deepak P. Edward, MD
Arch Ophthalmol. 2001;119(10):1558-1559. doi:10.1001/archopht.119.10.1558.
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A 3-YEAR-OLD girl with bilateral severe congenital glaucoma underwent an Ahmed valve implantation in the superonasal quadrant of the left eye following failure of 2 penetrating filtering procedures. Four months later, a second valve that controlled intraocular pressure (IOP) was placed superotemporally. Follow-up examination confirmed tubes in contact with the posterior corneal surface. Eight months after the initial procedure, the superotemporal tube had eroded, causing moderate conjunctival vasodilation and sterile infiltrate adjacent to the tube (Figure 1). During the removal of the tube and plate, a self-sealing wound without leak and a deep anterior chamber were noted. Five months after shunt removal, the superonasal tube continued cornea touch without erosion (Figure 2) with an IOP of 18 mm Hg.

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Figure 1.

Photomicrograph demonstrating transcorneal erosion of the suprotemporal tube surrounded by hyperemic conjunctiva. There is localized infiltrate (arrowhead) seen in the cornea around the extruded tube. Note the supronasal tube with surrounding corneal haze and presence of a central corneal opacity.

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Figure 2.

The anterior segment of the left eye following removal of the extruded tube. A triangular corneal opacity with surrounding superficial vascularization is evident in the area of erosion, with clearing of the central cornea.

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