Abstract
Purpose
To describe a novel tissue-sparing surgical technique—the Qidwai Quilt Pull-Over Patch-graft (Q-POP) technique—for the management of impending or established glaucoma drainage implant (GDI, ACP) tube exposure in high-risk eyes with conjunctival scarring and mechanical stress.
Methods
This report presents a single-case description of a monocular patient with severe nystagmus, extensive conjunctival fibrosis, and prior multiple ocular surgeries who developed progressive conjunctival thinning over a GDI (ACP) tube. A minimally invasive subconjunctival tunneling approach was used to deliver and position a scleral patch graft over the tube without a limbal-based peritomy.
Results
The Q-POP technique provided stable tube coverage with minimal conjunctival manipulation. Postoperatively, the graft remained flat and well-positioned with no evidence of re-exposure, conjunctival dehiscence, inflammation, or intraocular pressure instability during follow-up.
Conclusions
The Q-POP technique offers a safe, reproducible, and cost-neutral alternative for managing tube exposure in eyes with compromised conjunctiva where conventional peritomy-based repairs carry high risk. This method may be particularly valuable in eyes subjected to mechanical stress like nystagmus. Larger case series are warranted to assess long-term outcomes and broader applicability.
Keywords
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