Surgical Repair of the Extrusion of the Body of a PAUL Implant for Glaucoma

Abstract

The purpose of our article was to describe a simple but effective surgical technique performed on a patient with an extrusion of part of the body of a PAUL drainage implant for glaucoma. We present the case of a patient with refractory glaucoma and a history of multiple ocular interventions. A PAUL shunt was implanted and in the early postoperative period the patient presented extrusion of part of the implant body. An excessive scarring tissue at the lateral rectus muscle tendon hampered the placement of the lateral wing under the muscle; therefore, we decided to trim a part of it and suture the implant body to the sclera. The surgical technique that satisfactorily resolved the complication is described and shown in a video. This is the first time that such complication is described with the PAUL implant. We suggest that the intrinsic characteristics of the implant, mainly the dimensions, material, and thickness, made it possible for a potentially serious complication such as that described to be solved in a relatively simple and nontraumatic way for the eye.