Using a glaucoma seton can be very effective to control the intra-ocular pressure in many types of glaucoma, including challenging cases of neo-vascular glaucoma. During my 22 years of teaching residents, I taught about 200 residents how to perform implantation of a seton like the Ahmed valve (which is named after its inventor Prof. Dr. A. Mateen Ahmed) with which I have more than 1000 cases of experience. The footplate of this device should be secured to the sclera so that it does not migrate. In the method that I taught residents, we used 5-0 Mersilene suture to ensure that no sharp suture ends would poke through the conjunctiva. In our video today, our guest surgeon uses 6-0 polypropylene (6-0 Prolene) to secure the footplate using the flange technique. What is your preference? Comment below.
Here are some great links to learn. (1) How I taught Ahmed Vale implantation here: https://cataractcoach.com/2020/10/23/neo-vascular-glaucoma-ahmed-valve-fp7/ and (2) How to needle an encapsulated seton in the clinic and the post-op visit https://cataractcoach.com/2022/01/03/1337-how-to-needle-encapsulated-setons/
