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Management of a recurrent encapsulated bleb with a cost-effective non-valved glaucoma drainage device
  1. George Varghese Puthuran1,
  2. Hiruni Kaushalya Wijesinghe1,
  3. Mayank Jain2 and
  4. Paul Palmberg3
  1. 1Glaucoma Services, Aravind Eye Hospital and Postgraduate Institute, Madurai, Tamil Nadu, India
  2. 2Paediatric Ophthalmology, Aravind Eye Hospital, Madurai, Tamil Nadu, India
  3. 3Glaucoma Services, University of Miami School of Medicine, Bascom Palmer Eye Institute, Miami, Florida, USA
  1. Correspondence to Dr Mayank Jain; sandymayank{at}


Despite the advancements in the surgical management of glaucoma, childhood glaucoma remains a challenging surgical disease worldwide. An early adolescent boy with primary congenital glaucoma, status after glaucoma drainage device (GDD) implantation, on maximum medical therapy, was presented with a swelling in the superotemporal orbital region. The patient had undergone an uneventful GDD implantation 2 years prior to presentation. A similar swelling, which was diagnosed to be a Tenon’s cyst, had been excised on three earlier occasions. Given that the repeat capsular excision would also have the same likelihood of failure, and poor intraocular pressure control, a non-valved, cost-effective Aurolab aqueous drainage implant (AADI, Aurolab, Madurai, India) implantation was done inferonasally. In this patient, AADI proved to be a safe and effective alternative for the known GDDs.

  • glaucoma
  • congenital disorders
  • surgery

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  • Contributors GVP diagnosed the condition, investigated and provided treatment to the patient. HKW was involved in the collection of images with valid consent. MJ and HKW were involved in drafting the manuscript of the case report. HKW, MJ, PP and GVP revised the manuscript and maintained the standards of the manuscript as per BMJ protocols. The final manuscript was approved by all four authors, HKW, MJ, PP and GVP. All authors are responsible for the integrity and accuracy of the data provided.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.