METHOD FOR REMOVAL OF ANTIGLAUCOMA METAL SHUNT EX-PRESS WITH SINGLE-STAGE AHMED VALVE IMPLANTATION Russian patent published in 2024 - IPC A61F9/07 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to ophthalmology. Antiglaucoma metal shunt Ex-press is removed with single-stage implantation of the Ahmed valve. A retrobulbar anaesthesia is performed; a conjunctival incision is made around the operation area, and a conjunctival flap is formed between two rectus oculomotor muscles. Then Tenon's capsule is cut off from episclera with formation of conjunctival pocket, valve tube is washed with normal saline and viscoelastic. Further, the valve body is placed in the formed conjunctival pocket and the valve body is fixed to the sclera with two interrupted sutures at distance of 10 mm from the limb. Paracentesis is performed at 9 o’clock, after which 0.2 ml of viscoelastic is introduced into the anterior chamber, then scleral flap 4×4 mm is formed in the projection of the implanted metal shunt, after which a paracentesis is performed under a metal shunt in a projection of a round ligament with width of 1.8 mm. Then the shunt head is fixed with forceps and the shunt is turned through 90 degrees. Further, the shunt is removed, 23G needle is inserted through the hole from the shunt into the anterior chamber, and viscoelastic 0.1 ml is introduced. Then, through this hole, the tube of the Ahmed valve is implanted into the anterior chamber, after which the scleral flap is closed with 4 interrupted sutures along the edges. Further, at 1 mm from the limb, the tube together with the scleral flap is covered with a donor material measuring 6 mm by 8 mm and fixed with 4 interrupted sutures. Then the conjunctival incision is sealed with a continuous suture.

EFFECT: method enables achieving stable compensation of ophthalmotonus, preserving the surgically formed intraocular fluid (IOF) outflow tract, reducing the risk of valve tube protrusion, as well as reinforcing the surgical area with donor material, reducing the rate of postoperative complications.

1 cl, 1 ex