Novel use of fibrin sealant for scleral suture free placement of a glaucoma drainage device in advanced scleral thinning

Purpose This reports a case using fibrin glue to secure a glaucoma drainage device plate to the sclera where there is a concern with the use of suture. Observations A 13-year-old patient with congenital aniridia and associated glaucoma refractory to topical medications underwent implantation of a glaucoma drainage device (GDD) for improved intraocular pressure (IOP) control. The patient had substantial scleral thinning with staphyloma formation, potentially making the use of traditional suturing techniques problematic. Fibrin glue was used to attach the GDD plate, as well the tube and patch graft which has been previously described, without sutures. The patient tolerated the procedure well with a 41% reduction in IOP at six months follow-up with no migration of the GDD from its original position. Conclusions and importance The use of fibrin glue in ophthalmology can be expanded to include attachment of the GDD plate to the sclera in patients with suturing contraindications.