Seton in filtration glaucoma
 

This patient has a tube which enters the anterior chamber through the limbus region. This is a seton used for  glaucoma operation. Molteno's tube is the  most commonly used. Look for: previous trabeculectomy presence of signs indicating the underlying condition such as rubeosis iridis, ICE syndrome.

Questions:

1. What are the indications for using seton procedures?

Answer
It is used for refractory glaucoma for example:
neovascular glaucoma
previous multiple failed filtration procedures
conjunctival scarring from previous failed filtration making the development of a filtration bleb impossible
childhood glaucoma in which primary procedures have failed
 

2. What are the components of setons?

Answer
All setons contain a tube and a plate. The tube is inserted into the anterior chamber to drain the aqueous and is made up of either silicone or silastic. The plate forms the reservoir for the drained aqueous and is made up of plastic or silicone. The main difference between the different setons is in the design of the plates.

3. What is the most common complications of seton procedures?

Answer
Excessive drainage leading to hypotony is the main complication. Therefore, modification through valve insertion has been made to the tube and plate to make the seton pressure-dependent.

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