Glaucoma Surgery

Glaucoma Surgery Glaucoma and Cataract Surgeon and Surgical Glaucoma "Fixer-Upper" at Moorfields, London

16/11/2025

Paul Glaucoma Implant Surgery - What To Do in the Case of Overdrainage

The Paul Glaucoma Implant, stented with a ripcord suture, provides more predictable intraocular pressure control in the early postoperative period than prevous non-valved glaucoma drainage devcies. However, all implants and ripcords vary slightly in drainage rate on the operating table. In this video, I describe how I adjust for overdrainage, while minimising the risk of overcompensation and subsequent high postoperative intraocular pressure.

01/11/2025

Preserflo MicroShunts occasionally erode through conjunctiva and become exposed. Although this happens in less than 1% of cases, a potential risk factor is tenting of the subconjunctival portion of the PreserFlo. One simple extra scleral bite when stenting with a ripcord, might potentially reduce the risk.

30/10/2025

When implanting a pars plana tube in an eye with a previous vitrectomy, I would always ask for a further vitrectomy as the vitreous needs to be shaved right to the base at the tube entry site. I would not have expected the same to be necessary with this anterior chamber tube, but it has also blocked with vitreous. Beware of assuming that a previous vitrectomy is sufficient.

29/10/2025

It is sometimes necessary to sulcus position a tube on the crystalline lens in a phakic eye. This is not as problematic is popularly believed. In this eye, the tube tip of this Paul Glaucoma Implant has accidentally ended up in contact with the lens throiugh a prior iridectomy. This is unlikely to cause problems.


23/10/2025

An Unusual Complication - Drainage of Orbital and Suprachoroidal Haemorrhage

This patient developed nonspecific malaise and orbital symptoms one week after a Paul Glaucoma Implant. Step by step explanation of the eventual surgical exploration and management.

16/10/2025

Yamane-IOL and sutured secondary IOL-related hypotony seems to be increasing in frequency, possibly just to the increased popularity of these procedures. I've had 4 referred in the last 3 years. Here is a taster of what you might find.

13/10/2025

When fixing an eroded glaucoma tube, the first thing to consider is why it eroded in the first place.

05/10/2025

Stenting a PreserFlo MicroShunt, Ab Interno. This video is about a patient with chronic uveitis who developed chronic hypotony late after a Baerveldt Implant that had previously been connected to a PreserFlo MicroShunt after a revision for tube exposure. In order to correct the hypotony I attempted to place a suture inside the PreserFlo from the anterior chamber. Watch what happened.

30/09/2025

Remember this case that I posted recently? The surgery may have been interesting, but it is more important to see the outcome.

21/09/2025

Concealed intraocular foreign body - diagnosis and removal

This patient suffered an intraocular foreign body, but diagnosis and removal was delayed as it was not visible on B scan and not seen conclusively on CT scan.

foreign body

20/09/2025

Anterior chamber SF6 injection. Diagnostic or therapeutic? What for?

19/09/2025

Ripcord removal from a Baerveldt Implant 14 years after Implantation

The external subconjunctival portion of nylon ripcords degrade after around a year, whereas the intraluminal portion in the tube does not. The ripcord can then not be removed in the normal fashion.

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