| Summary: | This video walks the viewer through all the steps in the placement of an Ahmed glaucoma valve with the tube passed into the posterior chamber through the sulcus. This is possible in a pseudophakic eye and has the advantage of preventing possible corneal endothelial decompensation secondary to tube-corneal touch. Posterior chamber tube insertion may also be performed by combining surgery with phacoemulsification in older patients with lens changes. The video demonstrates use of the patient's own scleral flap to cover the tube, though it is also possible to use preserved sclera or pericardium for this purpose. Fibrin glue is then carefully used to close the edges of the conjunctiva, ensuring that none passes posteriorly into the sub-Tenon's space. Video segments also discuss priming of the valve, conjunctival peritomy, sub-Tenon dissection, and how to suture the valve plate. The final segments of the video detail how to trim the tube and the insertion of the tube into the posterior chamber, as well as how to anchor the tube to the sclera via a stay suture, and best practices to closing the scleral flap and conjunctiva.
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