The Modified Schocket Procedure
Glaucoma is not infrequently encountered after retinal detachment surgery. Surgical management of glaucoma in eyes with preexisting scleral buckles can be challenging. Trabeculectomy has a high failure rate because poor conjunctival health limits bleb survival, and glaucoma drainage devices have large-sized plates and their implantation is often difficult if a scleral buckle is present. The modification to the original Schocket procedure described by Sidoti and colleagues in which a silicone tube is inserted into the capsule of a preexisting scleral buckle is a good surgical option. This anterior chamber tube shunt to an encircling band (ACTSEB) is a safe and effective option to control intraocular pressure (IOP) in these cases. Reported success in lowering IOP ranges between 80 and 90 % in published retrospective case series. Reported complications include immediate postoperative hypotony, serous choroidal detachments, conjunctival wound leak, hyphema, and tube obstruction. The use of current glaucoma drainage devices in eyes with preexisting scleral buckles has also been described with comparable outcome and complication rates. The modified Schocket procedure is particularly useful when significant conjunctival and subconjunctival scarring is present in eyes with preexisting scleral buckles.
KeywordsSchocket ACTSEB Retinal detachment Scleral buckle Conjunctival scarring Glaucoma drainage device Baerveldt Molteno
Compliance with Ethical Requirements
Luis E. Vazquez and Steven J. Gedde declare that they have no conflict of interest. No human or animal studies were carried out by the authors for this article.
Modified Schocket Procedure; Ahmad A. Aref, MD (MPG 75,510 kb)
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