Peritubular filtration as cause of severe hypotony after ahmed valve implantation for glaucoma

PURPOSE: To report peritubular filtration as the cause of severe hypotony a fter Ahmed valve implantation. METHODS: Interventional case report. In a 65-year-old man with primary open angle glaucoma, ultrasound biomicroscopy was used to image the peritubular region of his right eye that had severe hypotony during the early postoper ative period after an Ahmed valve implantation. RESULTS: The ultrasound biomicroscopy examination showed peritubular filtra tion. Additional surgery consisting of tube extraction, closure of the prev ious insertion opening, reformation of the anterior chamber with vis, coela stic, and reintroduction of the tube through a new paracentesis was perform ed to solve this complication. Twenty-four hours postoperatively, the intra ocular pressure increased to 10 mm Hg. During the 6-month follow-up, the me an intraocular pressure was 16.36 mm Hg (standard deviation, 1.45). CONCLUSION: The possibility of peritubular filtration should be considered in eyes with severe hypotony after restrictive valve implantation. (C) 2001 by Elsevier Science Inc. All rights reserved.