Corneal Graft Failure

• Glaucoma tube implant surgeries (aqueous shunting procedures) have become an increasing popular alternative to conventional filtration surgery in patients with refractory glaucoma (previous failed glaucoma surgery or poor surgical prognosis).

Complications

• Early post-operative complications associated with tube shunt insertion include ocular hypotony, inflammation, bleeding, infection or blockage of the tube.
• Late postoperative complications include corneal edema due to a persistent flat chamber from hypotony, corneal decompensation from tube-cornea touch, cataract, tube migration, scleral erosion, and diplopia.

Management

• Observation for bleeding, worsening hypotony, increasing IOP or inflammatory signs.
• Medical treatment for inflammation or infection.
• Tube repositioning or exchange.
• Penetrating keratoplasty for decompensated cornea.