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Dear Francisco B. We have used all kind of covering tissues over the tube and I can frankly tell you that the best one is the patient’s own tissue, and the second one is the donor cornea-sclera. Here in this case, the erosion is not related with the tissue issue, it is solely related with the rubbing. The patient was a child with mental retardation and she used to rub her eyes. We decided to cover the erosion with amniotic membrane, because it was the only tissue we had at that time during her examination under general anesthesia. But related with our technique with amniotic membrane shown here, it ended up with completely healing of the conjunctiva. She is still coming to follow-ups, with no erosion at all. That is why we want to share it..Thank you for your interest and comments.

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Dear Umut Duygu U. There is no doubt to confirm the patency of AGV before the insertion, and it is a must. Because of time issues the video was edited and this section was not shown. Regarding the tunnel which was 3 mm in this case with our approach, we are very confident in terms of safety and efficacy. Thank you for your interest and comments.

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The tunnel was short and it could decrease the success of the operation. Additionally, before starting the operation, did you check whether the valve was working or not?

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I´m afraid amniotic membrane would not be enough to resist the erode action of a protuding tube over the sclera. It will dissapear, giving a momentary chance to heal to the conjunctiva-tenon tissue over the tube. But the cause of erosion is still there. I don´t know if this technique was succesful for you previously, but I modestly suggest a longer intrascleral tunnel for the tube and/or new solid covering tissue as donor sclera or cornea; fascia lata or pericardium.

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