| 본문 : We present a case of ocular hypotony after Ahmed Glaucoma Valve (AGV; New World Medical, Rancho Cucamonga, CA, USA) implantation that was resolved by stenting using two 5-0 nylon threads with an ab interno approach. A 50-year-old man with neovascular glaucoma underwent AGV implantation to control intraocular pressure (IOP). After the AGV implantation, the IOP ranged from 7 to 10 mmHg without complications. However, 2 weeks after the surgery, the IOP suddenly decreased to 2 mmHg and vision also decreased from 20/400 to hand motion. Given that the ocular hypotony occurred 2 weeks post-operatively, excessive aqueous drainage though the tube due to loosening of tube ligation was suspected. To elevate IOP by intraluminal stenting with an ab interno approach, a clear corneal incision was made opposite to the tube. A 5-0 nylon thread was inserted into the tube lumen by using forceps. In the same manner, the second 5-0 nylon thread was inserted into the tube lumen. Ten days after this procedure, IOP increased to 29 mmHg. Timolol/dorzolamide fixed-combination eye drops were applied twice daily and the IOP decreased to 10 mmHg. Both of the threads were removed 30 days after stenting by retracting the end of the thread though the previous clear corneal incision site using forceps, and timolol/dorzolamide fixed-combination eye drops were stopped. IOP ranged from 10 to 13 mmHg for 6 months after this procedure and vision recovered to 20/400. We think that ab interno tube stenting using two 5-0 nylon threads may be an effective and safe method to manage postoperative ocular hypotony after AGV implantation. |