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PURPOSE: To discuss the clinical problem of exposed anterior segment tubes, to review the literature on revision surgery, and to present my method of revision for tube exposure. METHODS: Review of the pertinent literature and tabulation of complications from the author's cases of revision surgery. RESULTS: The risk of endophthalmitis requires that all cases of exposed anterior segment tube undergo revision with a patch graft. Simple conjunctival closure is inadequate. A patch graft of collagenous human autograft or allograft material is necessary to prepare the eye for complete healing and resolution of the exposure. Methods of revision from the literature are reviewed and presented, along with the author's method of revision. Complications, reported and potential, are discussed. CONCLUSIONS: All exposed anterior segment tubes should be revised with patch graft to resolve the exposure and avoid endophthalmitis. Several methods of revision are available, and the rate of complications is low.
Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, USA. kalenakj@netscape.net
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)