The "Pull-Through" Suture; Facilitating Watertight Anterior Chamber Entry and Minimizing Early Hypotony in Glaucoma Tube Surgery.

Tube procedures are increasing world wide. One failing of all tube procedures is early hypotony; most commonly attributable to entry site leak as ligature and stent sutures become standard surgical practice. The tube versus trabeculectomy and primary tube versus trabeculectomy study protocols employ 21 G anterior chamber entry; however, entry site leaks can still occur often requiring suturing. Twenty-three-gauge entry produces a reliably watertight seal but can be technically challenging. The "Pull-Through" suture facilitates efficient and reproducible tube insertion while avoiding entry site trauma.