TAG (Tube and Graft) Sandwich Technique: A Novel Single-Stage Scleral Reinforcement and Aqueous Drainage Tube Implantation
Purpose. Refractory glaucoma patients continue to require surgical intervention in the form of trabeculectomy surgery or glaucoma drainage device (GDD). Those patients that require a GDD but have thin sclera or scleromalacia present a challenge. Methods. In this article, we present a novel “TAG sand...
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Wiley
2021-01-01
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| Series: | Case Reports in Ophthalmological Medicine |
| Online Access: | http://dx.doi.org/10.1155/2021/6698919 |
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| author | Faisal Ahmed Nada G. Mohamed |
| author_facet | Faisal Ahmed Nada G. Mohamed |
| author_sort | Faisal Ahmed |
| collection | DOAJ |
| description | Purpose. Refractory glaucoma patients continue to require surgical intervention in the form of trabeculectomy surgery or glaucoma drainage device (GDD). Those patients that require a GDD but have thin sclera or scleromalacia present a challenge. Methods. In this article, we present a novel “TAG sandwich” single surgical procedure in which thinned sclera is reinforced with a pericardial patch graft (“bottom layer of the sandwich”) allowing safe implantation of the GDD (“the tube sandwich filling”) and then placing another patch graft on top of the tube part of the GDD (“top layer of the sandwich”). The surgery was performed on an open-angle glaucoma patient with a generalized thin sclera and uncontrolled intraocular pressure despite maximal topical medication and oral acetazolamide. Results. Reinforcing a compromised sclera with a pericardium patch graft allowed the safe implantation of a glaucoma drainage device. The patient’s intraocular pressure was safely controlled at 7 mmHg almost 1-year postsurgery without intraocular pressure-lowering drops. Conclusions. This scleral strengthening procedure can be considered by readers in other ocular surgeries where there is a risk of scleral perforation, as well as part of a combined surgery where refractory glaucoma patients with thin sclera require scleral reinforcement to allow for safer implantation of a glaucoma drainage device. |
| format | Article |
| id | doaj-art-b2d05a658d9740888f87288396568f74 |
| institution | Kabale University |
| issn | 2090-6722 2090-6730 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Ophthalmological Medicine |
| spelling | doaj-art-b2d05a658d9740888f87288396568f742025-02-03T05:44:45ZengWileyCase Reports in Ophthalmological Medicine2090-67222090-67302021-01-01202110.1155/2021/66989196698919TAG (Tube and Graft) Sandwich Technique: A Novel Single-Stage Scleral Reinforcement and Aqueous Drainage Tube ImplantationFaisal Ahmed0Nada G. Mohamed1The Western Eye Hospital, Imperial College Healthcare NHS Trust, 153-173 Marylebone Rd, London, UKThe Ophthalmology Department, Faculty of Medicine, Alexandria University, Champollion Street, Alexandria, EgyptPurpose. Refractory glaucoma patients continue to require surgical intervention in the form of trabeculectomy surgery or glaucoma drainage device (GDD). Those patients that require a GDD but have thin sclera or scleromalacia present a challenge. Methods. In this article, we present a novel “TAG sandwich” single surgical procedure in which thinned sclera is reinforced with a pericardial patch graft (“bottom layer of the sandwich”) allowing safe implantation of the GDD (“the tube sandwich filling”) and then placing another patch graft on top of the tube part of the GDD (“top layer of the sandwich”). The surgery was performed on an open-angle glaucoma patient with a generalized thin sclera and uncontrolled intraocular pressure despite maximal topical medication and oral acetazolamide. Results. Reinforcing a compromised sclera with a pericardium patch graft allowed the safe implantation of a glaucoma drainage device. The patient’s intraocular pressure was safely controlled at 7 mmHg almost 1-year postsurgery without intraocular pressure-lowering drops. Conclusions. This scleral strengthening procedure can be considered by readers in other ocular surgeries where there is a risk of scleral perforation, as well as part of a combined surgery where refractory glaucoma patients with thin sclera require scleral reinforcement to allow for safer implantation of a glaucoma drainage device.http://dx.doi.org/10.1155/2021/6698919 |
| spellingShingle | Faisal Ahmed Nada G. Mohamed TAG (Tube and Graft) Sandwich Technique: A Novel Single-Stage Scleral Reinforcement and Aqueous Drainage Tube Implantation Case Reports in Ophthalmological Medicine |
| title | TAG (Tube and Graft) Sandwich Technique: A Novel Single-Stage Scleral Reinforcement and Aqueous Drainage Tube Implantation |
| title_full | TAG (Tube and Graft) Sandwich Technique: A Novel Single-Stage Scleral Reinforcement and Aqueous Drainage Tube Implantation |
| title_fullStr | TAG (Tube and Graft) Sandwich Technique: A Novel Single-Stage Scleral Reinforcement and Aqueous Drainage Tube Implantation |
| title_full_unstemmed | TAG (Tube and Graft) Sandwich Technique: A Novel Single-Stage Scleral Reinforcement and Aqueous Drainage Tube Implantation |
| title_short | TAG (Tube and Graft) Sandwich Technique: A Novel Single-Stage Scleral Reinforcement and Aqueous Drainage Tube Implantation |
| title_sort | tag tube and graft sandwich technique a novel single stage scleral reinforcement and aqueous drainage tube implantation |
| url | http://dx.doi.org/10.1155/2021/6698919 |
| work_keys_str_mv | AT faisalahmed tagtubeandgraftsandwichtechniqueanovelsinglestagescleralreinforcementandaqueousdrainagetubeimplantation AT nadagmohamed tagtubeandgraftsandwichtechniqueanovelsinglestagescleralreinforcementandaqueousdrainagetubeimplantation |