The use of nonabsorbable suture ligatures for glaucoma drainage devices

Nonvalved glaucoma drainage devices are typically ligated to prevent early postoperative hypotony. However, visualization of these sutures can be difficult owing to posterior placement and thick Tenon capsules that can develop over the tube. As a result, tube ligations are typically performed using absorbable sutures, which can open at unpredictable times, or rip cords that need to be removed from the eye. We present a technique and small consecutive case series for the use of nonabsorbable tube ligatures with postoperative suture lysis. This technique has the advantages of providing predictable control of postoperative intraocular pressure (because the ligature can be lysed at any time) and eliminating the need to pull a tube rip cord. There may also be a potential for thinner blebs and lower long-term intraocular pressure if the ligatures are left in place for longer periods.