Polypropylene suture–guided valve tube for posterior chamber implantation in patients with pseudophakic glaucoma

We describe a new surgical procedure for implanting a glaucoma drainage tube in the posterior chamber. A needle with a 10-0 polypropylene suture is introduced into the posterior chamber, and a 23-gauge needle is also introduced as the barrel on the polypropylene needle tip. After the 23-gauge needle is withdrawn from the posterior chamber, the polypropylene needle tip is pulled and the suture crosses the anterior and posterior chambers. A sliding knot is made around the drainage tube. The tube is pushed into the scleral tunnel and posterior chamber as the suture is pulled to position the tube. The knot is loosened and the suture removed from the eye by pulling from either side. This procedure is easy and effective for implanting a tube in the posterior chamber in pseudophakic eyes and is indicated after penetrating keratoplasty or in eyes with compromised endothelial function.