Tube Erosion with Scleral Melting after Ahmed Valve Implantation Using a Synthetic Dural Substitute

PURPOSE: The objective of this case report was to present tube erosion of Ahmed valve implantation using a synthetic dura substitute (Neuro-Patch®, B. Braun, Boulogne, France). CASE SUMMARY: Tube erosion was caused by dissolution of the conjunctiva and partial-thickness scleral tunnel in 5 patients who received Ahmed valve implantation using a synthetic dura substitute for glaucoma treatment 2 to 4 months after the operation. Furthermore, the patients required re-operation for preventing secondary complications such as endophthalmitis. CONCLUSIONS: This case series using a synthetic dura substitute in Ahmed valve implantation demonstrated the risk of tube erosion with scleral tunnel melting and following secondary complications even with a partial-thickness scleral tunnel method.

Synthetic dural graft septoplasty in epistaxis from hereditary hemorrhagic telangiectasia / Septoplastia con injerto de dura sintética en epistaxis por telangiectasias hemorrágicas hereditarias

Abstract It is an autosomal dominant vascular disorder, which has a variety of clinical manifestations, with epistaxis being one of the most common. Many treatment options exist for epistaxis, but with no consensus on which is the method of choice. We describe the case of a patient with hereditary hemorrhagic telangiectasia (HHT) secondary epistaxis with septoplasty managed with synthetic hard graft, which improved intensity and frequency of bleeding episodes. This technique is a variant of the septodermoplasty described by several authors, but the use of synthetic dura can help in obtaining better results and avoid taking skin grafts from other sites different from the surgical site.

Resumen Esta condición es un trastorno vascular autosómico dominante, que tiene una variedad de manifestaciones clínicas; entre las más comunes, se encuentra epistaxis. Existen múltiples opciones terapéuticas para la epistaxis, pero no hay un consenso sobre cuál es el método de elección. Se describe el caso de un paciente con epistaxis secundaria a telangiectasias hemorrágicas hereditarias (THH) manejado con septoplastia con injerto de dura sintética, la cual obtuvo mejoría en la intensidad y frecuencia de los episodios de sangrados. Esta técnica es un variante de la septodermoplastia descrita por diversos autores, pero el uso de dura sintética puede ayudar a obtener mejores resultados y evita toma de injertos dérmicos de otros sitios diferentes al sitio quirúrgico.