Tube-shunt surgery (seton glaucoma surgery)
involves placing a flexible plastic tube with an attached silicone drainage
pouch in the eye to help drain fluid (aqueous humor) from
the eye. This type of surgery is usually done after a trabeculectomy that
failed. If a person already has or is likely to form scar tissue in the eye,
this type of surgery may be done at the start.
can be done with the person asleep (general anesthesia) or with anesthesia
applied only to the eye (local anesthesia).
Primary congenital glaucoma (PCG) is an eye disease that affects children between the ages of birth and 3 years. It is one type of glaucoma. Glaucoma refers to a group of diseases that affect the eye and cause major damage to the optic nerve.
Primary congenital glaucoma is rare. It affects about one in every 10,000 infants. But it is serious and needs attention. Untreated primary congenital glaucoma is a major cause of childhood blindness.
"Primary" means the disease does not result from another...
The person does not have to be
admitted to the hospital. But children may stay in the hospital overnight
following surgery. And in some cases, your doctor may recommend that you stay
in the hospital overnight following surgery.
The person usually
sees the doctor within a day after tube-shunt surgery and 2 to 5 other times
during the 6 weeks after surgery, depending on the person's recovery.
Initially after surgery antibiotics may be applied to the eye.
Antibiotics may also be injected under the lining of the eyelid (conjunctiva)
at the time of the surgery. For the first night only, the eyelid is usually
taped shut, and a hard covering (eye shield) is placed over the eye.
Corticosteroid medicines are usually applied to the eye for about 1 to 2 months
after surgery to decrease inflammation in the eye.
activity that might jar the eye needs to be avoided after surgery. People
usually need to avoid bending, lifting, or straining for several weeks after
After surgery, people who have problems with
constipation may need to take laxatives to avoid straining while trying to pass
stools. Straining can raise the pressure inside the eye. Your doctor may
suggest wearing a shield at night to avoid rubbing the eye when you
Why It Is Done
Tube-shunt surgery is most often
used for people who have had previous trabeculectomy surgery that was not
successful, usually due to scarring.
Tube-shunt surgery is also
frequently used to treat glaucoma when a person has a:
Difficult case of glaucoma and the doctor
thinks that other surgical methods may fail.
Form of glaucoma in
which new blood vessels grow on the colored part of the eye, or iris. This is
neovascular glaucoma and occurs primarily in people
with diabetes or who have vascular diseases in the eye. It is difficult to
Although tube-shunt pouches are
becoming popular, they are not often used as a first treatment for glaucoma.
The advantage of tube-shunt surgery for glaucoma is that there is less chance
of severe scarring that can block the drainage opening. This can be an
important consideration for people who have had prior surgery for glaucoma that
did not work. But the complications from tube-shunt surgery can be serious too.