Primary valve malfunction of the Krupin eye valve with disk

Purpose. To examine the management and possible causes of primary valve malfunction of the Krupin eye valve with disk. Methods. The authors reviewed the results of 113 patients undergoing implantation of the Krupin eye valve with disk and identified 8 patients with primary valve malfunction requiring surgical revison. Results. Valve revision involved manipulation (1 case), explantation of the malfunctioning valve and implantation of a new valve (2 cases), and amputation of the valve (5 cases). Six of eight patients had final intraocular pressures of less than 21 mm Hg on one or no medications at a mean interval of 15.9 months (range 5-36 months) after surgical revision. Transient postoperative hypotony was noted in 3 patients and chronic hypotony with loss of light perception in I patient. One explanted valve was examined and found to have partially fused leaflets. Conclusions. Surgical revision in cases of primary valve malfunction of the Krupin eye valve with disk may be accomplished relatively safely with an acceptable level of postoperative complicatons. The etiology of primary valve malfunction may be related to the sterilization process and prolonged storage prior to implantation.