This is a complex case where a patient with anirida and multiple other ocular issues underwent placement of a kerato-prosthesis device with implantation of an Ahmed glaucoma seton device. While the corneal issues stabilized, the patient suffered from erosion of the tube through the conjunctiva. The seton tube was removed and CPC was performed to control the glaucoma but the decision was made, many years prior, to leave the footplate of the Ahmed valve in position. That was good for a while but eventually that also eroded through the conjunctiva.
When a glaucoma seton such as an Ahmed valve has eroded through the conjunctiva, intra-operative management must prioritize tissue preservation and safe device removal without offering step-by-step technical instructions. Particular attention is paid to protecting healthy conjunctiva for future coverage. The plate is released from its encapsulated bed with controlled traction to minimize scleral stress and avoid bleeding. Reconstruction focuses on achieving watertight conjunctival coverage, often requiring advancement or grafting, to restore surface integrity and reduce the risk of recurrent exposure or infection. Great job on a tough case!
