Revision for exposed anterior segment tubes.
OBJECTIVE
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.
Kalenak
Jeffrey W
JW
Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, USA. kalenakj@netscape.net
D000869:Anterior Eye Segment / Q000473:pathology / Q000601:surgery*; D001082:Aqueous Humor / Q000378:metabolism; D003229:Conjunctival Diseases / Q000209:etiology / Q000601:surgery*; D005548:Foreign-Body Migration / Q000209:etiology / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D006801:Humans; D007431:Intraoperative Complications; D013508:Ophthalmologic Surgical Procedures; D011183:Postoperative Complications; D012086:Reoperation