Fig. 1

Surgical Technique for Scleral Tunneling Combined with Tenon Coverage in Glaucoma Drainage Valve Surgery. A-C: Initial conjunctival and scleral incisions are made at the bulbar junction, with radial incisions at both ends for exposure. D-E: The AGV implant is placed in a supratemporal position, secured to the sclera 8–10 mm from the limbus with a 6 − 0 non-absorbable suture. F-G: A scleral tunnel is created using a 23-gauge needle, extending from the scleral surface into the anterior chamber, approximately half the thickness of the sclera. H: Insertion of the drainage tube into the anterior chamber through the scleral tunnel, taking care not to contact the corneal endothelium or the iris. I: Applying an “8” suture configuration with an 8 − 0 absorbable suture to anchor the tube to the superficial sclera, 6 mm from the corneal limbus. J: Dissection of the Tenon’s capsule under the incision to cover the AGV implant, secured with 8 − 0 absorbable sutures. K: Closure of the conjunctival flap with interrupted 10 − 0 non-absorbable sutures. L: Postoperative appearance showing the covered AGV implant with no visible exposure