The FIRE technique – A tube ligation alternative

Nonvalved glaucoma drainage devices (GDDs) carry a risk of early hypotony due to unregulated flow prior to capsule formation. Temporary flow restriction occurs through methods such as absorbable ligature sutures and intraluminal ripcords. Here, we propose an alternative approach, the Flanged Intraluminal Ripcord Element (FIRE) technique, that eliminates the need for a ligature suture and avoids the unpredictability associated with ligature autolysis. A patient case is discussed that demonstrated adequate prevention of hypotony and successful intraocular pressure reduction upon ripcord removal. The FIRE technique provides predictable flow control in the early postoperative period of nonvalved GDDs.