The efficacy of a modified ACTSEB (anterior chamber tube shunt to an encircling band) procedure

PURPOSE: To evaluate the efficacy of a modified anterior chamber tube shunt to an encircling band (ACTSEB) procedure for treating intractable glaucoma after scleral buckling procedure. METHODS: A retrospective review of medical records was performed on 7 eyes of 5 patients who underwent a modified ACTSEB procedure to treat intractable glaucoma after an encircling procedure. The modified ACTSEB procedure was performed using a silicone tube with its distal end inserted into the fibrous capsule around a scleral buckle and its proximal end inserted into the anterior chamber. Preoperative and postoperative intraocular pressure (IOP), number of antiglaucoma medications, visual acuity, and complications were recorded. Success was defined as a final IOP of >6 mm Hg and <21 mm Hg with or without medication. Among them qualified success was defined as a final IOP of <22 mm Hg with antiglaucoma medication, and complete success as the same IOP without medication. RESULTS: The overall success rate was 86% (6/7). Qualified success rate was 71% (5/7), and the complete success rate 14% (1/7). No case of hypotony, shallow anterior chamber, fibrous tube occlusion, tube obstruction by lens or iris, conjunctival wound leak, hyphema, or epithelial ingrowth occurred. The only complication was of inferior migration of the silicone tube into the anterior chamber in 2 cases. One of these led to corneal decompensation and subsequent tube removal due to tube migration, and the other underwent tube repositioning at 14 months postoperatively. CONCLUSIONS: The modified ACTSEB procedure provides an efficient means of treating intractable glaucoma after scleral buckling procedure.