Glaucoma drainage devices have been used for over three decades in refractory glaucoma, and recent trials recommend their use earlier in the disease process. Corneal decompensation because of tube–cornea touch appears to be one of the main late postoperative complications. The endothelial failure begins with local corneal oedema that subsequently becomes generalized.
Interventions to rectify this complication include tube repositioning that involves major surgery or the relatively easier trimming of the tube through two paracentesis incisions. Occasionally explantation of the device is necessary. Recently Bochmann and Azuara-Blanco described a simple and novel technique of tube repositioning using transcameral sutures that we used and documented with pre- and postoperative photographs.
The use of transcameral sutures to manage tube–corneal touch resulted in reduction of corneal oedema and haze by repositioning the tube away from the endothelium. The procedure is less complex and safer than the more invasive option of tube repositioning via a steeper scleral tunnel or through a new insertion site. The photographs clearly illustrate the improved position of the tube and subsequent improvement of corneal oedema. This technique of transcameral suture is simple to use and is likely to be used more frequently in managing tube–cornea touch.