67 © Springer Nature Singapore Pte Ltd. 2019
M. Gandhi, S. Bhartiya (eds.), Glaucoma Drainage Devices,
https://doi.org/10.1007/978-981-13-5773-2_10
AADI Technique
Suresh Kumar and Sahil Thakur
10.1 Introduction
Aurolab aqueous drainage implant (AADI) has
been marketed in India by Aurolab, Madurai,
India, since June 2013. AADI is a non-valved
device that is useful in refractory glaucomas
when other methods to control the intraocular
pressure have failed. It is made of permanent
implantable grade silicone, a proven material for
patient safety [1]. The implant plate surface area
is 350 mm
2
, and it has lateral wings that are
designed to be placed under the rectus muscle. It
is a 35 mm silicon tube attached to a 13 mm con-
vex radius plate which conforms to the curvature
of the globe. It has additional holes to facilitate
anchoring of the end plate to the sclera so as to
minimise device movement. There are various
surgical methods of implanting a glaucoma
drainage device which have been elucidated in
this chapter.
10.2 Dissection
of the Conjunctiva
A peripheral clear corneal 6-0 Vicryl or 6-0
Prolene suture to provide traction and exposure
of the surgical field (Fig. 10.1).
The conjunctival peritomy is started in the
supero-temporal quadrant to raise a fornix-based
conjunctival flap. The preferred location for the
implant is supero-temporal quadrant because of
more space available in this area. In case of scar-
ring in this region, the supero-nasal quadrant can
be used for implant placement. The inferior
quadrants are not preferred because of risk of
endophthalmitis. Before making a conjunctival
incision, it is preferable to inject around 0.5 ml of
4% xylocaine with adrenalin solution under the
conjunctiva that aids both in haemostasis and
mechanical separation of the tissue from the
sclera. Additionally, most of the eyes requiring
S. Kumar (*)
Department of Ophthalmology, GMCH,
Chandigarh, India
S. Thakur
Department of Ocular Epidemiology, Singapore Eye
Research Institute, Singapore, Singapore
10
Electronic Supplementary Material The online version
of this chapter (https://doi.org/10.1007/978-981-13-5773-
2_10) contains supplementary material, which is available
to authorized users.
Fig. 10.1 Corneal traction suture and dissection bleb
raised using lignocaine