title: Upper eyelid tarsoconjunctival flap for the treatment of Ahmed valve plate exposure.
abstract: OBJECTIVE
  The aim of this study was to describe a new technique for the treatment of Ahmed valve plate exposure used in a patient with recurrent valvular plate exposure.
  
  
  BACKGROUND
  An important complication of glaucoma drainage devices is its exposure. The treatment options reported include the use of different grafts covered by mucosa or conjunctiva. Despite these treatments many valves reexpose, especially in patients with previously damaged conjunctiva.
  
  
  METHODS
  We report the case of a patient with Acanthamoeba keratitis and secondary angle closure glaucoma, who underwent a penetrating keratoplasty and an Ahmed valve implantation, and presented with repeated valvular plate exposure. After consecutive unsuccessful coverage methods, a novel use of a tarsoconjunctival flap was performed to solve this complication.
  
  
  CONCLUSIONS
  Upper eyelid tarsoconjunctival flap is a useful option to cover exposed valvular plates in patients where traditional methods have failed.
authors.affiliation: *Department of Oculoplastic, Orbit and Lacrimal Pathway †Department of Glaucoma Instituto de Microcirugia Ocular, Barcelona, Spain.
authors.forename: Ramón
authors.initials: R
authors.lastname: Medel
authors.forename: Vanessa
authors.initials: V
authors.lastname: Hristodulopulos
authors.forename: Stefania
authors.initials: S
authors.lastname: Mazzarella
authors.forename: Elena
authors.initials: E
authors.lastname: Arrondo
mesh_terms: D015823:Acanthamoeba Keratitis / Q000601:surgery*; D000328:Adult; D005143:Eyelids / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D015812:Glaucoma, Angle-Closure / Q000601:surgery*; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000379:methods*; D008297:Male; D013524:Surgical Flaps; D055815:Young Adult