The Qidwai quilt pull-over patch-graft (Q-POP) technique: A novel method for repairing glaucoma tube exposure in conjunctival adhesions.
Umair Qidwai
✦ AI-curated · Sources linked
Case in brief
A monocular patient with severe nystagmus, extensive conjunctival fibrosis, and multiple prior ocular surgeries developed progressive conjunctival thinning over a glaucoma drainage implant tube. The report describes repair using the Qidwai Quilt Pull-Over Patch-graft technique: a scleral patch graft was positioned over the tube through minimally invasive subconjunctival tunneling, without a limbal-based peritomy. During follow-up, the graft remained flat and well positioned, with no re-exposure, conjunctival dehiscence, inflammation, or intraocular pressure instability.
What made this case unusual
The technique was designed for a high-risk eye with scarred conjunctiva and mechanical stress from severe nystagmus, using a subconjunctival tunnel to place the patch graft without a limbal-based peritomy.
Diagnostic / clinical pearl
In eyes with compromised conjunctiva, a subconjunctival tunneling approach may allow tube coverage while limiting conjunctival manipulation; this report describes stable coverage in one patient.
Why it matters
The authors propose Q-POP as an alternative when conventional peritomy-based repair is considered high risk, while noting that larger case series are needed to assess longer-term outcomes and broader applicability.