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A new glaucoma drainage implant, silicone tube attached to an expanded polytetrafluoroethylene (e-PTFE) membrane, was used in patients with recalcitrant glaucomas. Aqueous was shunted via the silicone tube to reservoir which was formed under the posterior Tenon´s capsule by an oval piece of e-PTFE memberane, (japan Gore-tex Inc., Tokyo) was 0.1mm thick, malleable and foldable. Therefore, the e-PTFE membrane of the implant could be introduced through a small incision of a quadrant conjunctiva in folded form and then spreaded over the sclera. The implant had been placed in 18 eyes of 17 patients with one or more unsuccessful glaucoma filtration surgeries including three neovascular glaucoma (NVG) patients. After follow-up of peroids ranging between seven and 18 months (mean： 10 months), 15 of the 18 eyes (83％) had controlled intraocular pressure (IOP) using 20 mmHg as normal. Three patients were not on any glaucoma medication. Seven patients required one β-blocker. Five patients were on one β-blocker and pilocarpine or a small dose of acetazolamide on their final visits. Three eyes with an unsuccessful surgery had an IOP over 25 mmHg in spite of maximum tolerated medical therapy. A postequatorial filtration bleb was found in each operated eye following removal of 5-0 cat-gut threaded through the silicone tube for the prevention of aqueous overdrainage. Postoperative complications included hyphema and fibrinous aqueous in the eyes with NVG(17％), prolonged shallow chamber(22％ ), obstruction of the silicone tube in the anterior chamber(6％), and choroidal datachment(6％) silicone tube in the anterior chamber (6％ ), and choroidal detachment(6％). The required conjuctival incision for the installation of the e-PTFE drainage implant was less than 90˚ and the overall surgical procedures seemed to be simple.
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