Exposure of Supramid Stent – A Hornet’s Nest

Flow restriction is essential to prevent early postoperative hypotony with non-valved glaucoma drainage devices.[1] It is usually achieved with either tube ligation, an intraluminal stent suture or both. Ideally, this suture is tunnelled beneath the bulbar conjunctiva toward the inferior fornix, where it can be accessed and removed after 6 weeks if required, known as the ripcord technique. However, exposure of this stent in the immediate postoperative period could lead to serious complications such as endophthalmitis.[2,3] A 10-year-old child diagnosed with glaucoma following multiple vitreoretinal (VR) surgeries, underwent Aurolab Aqueous Drainage Implant (AADI) with Supramid (3-0 nylon multifilament suture) stenting. One month postoperative follow up of the child revealed exposed Supramid stent (Figure 1-black circle). Immediately, Supramid removal was done under strict aseptic precautions. It is crucial to place the Supramid stent in the subtenon space with meticulous conjunctival closure to prevent this complication.Figure 1: (A) Slit lamp image of the right eye showing AADI tube with exposure of the Supramid stent (black circle). AADI = Aurolab aqueous drainage implantFinancial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.