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ARTHUR SIT: So we're putting in a corneal traction suture. This will let us rotate the eye into position. And making the incision 4 millimeters back gives us a nice, watertight closure at the end. And we're just dissecting underneath the Tenon's layer now, creating a space for the tube.

We're now going to isolate the muscles of the eye. And the tube needs to go underneath the muscle, so we need to be sure where they are. And so that was the superior rectus muscle, and we're going to isolate the lateral rectus muscle now.

OK. So now that we've isolated the muscles, we can start preparing the tube for implantation, and then ligate the tube so that we don't have excessive flow and low pressures at the beginning of the postoperative period.

And so now that we've achieved hemostasis, we're going to place the tube that we prepared. Now we have to be careful that it goes underneath the rectus muscles, so we have them isolated. So we'll hold one up and slip the tube underneath. That's one.

And then the other side, we'll slip it under the other muscle. And we'll check the tube is free to move posteriorly. But we want to make sure that it's locked at the muscles anteriorly, which we see that it is.

And the next step is we need to suture down the tube to the sclera. We want it to be at least 8 to 10 millimeters from the limbus. And we want to see and make sure that the tube is stable. We have a little bit of play there-- 1.12. So I'm going to put in a third anchoring suture.

All right, so we now want to trim the tube to the correct length. We're now going to mark it at 1 millimeter from the limbus. OK, and so then we're going to make a passage for the tube into the anterior chamber. It looks like about the right length. It's nice and posterior, just anterior to the iris, and that looks good.

OK, so since the tube was ligated, we actually want to lower the pressure immediately. So we're going to make a little hole in the side of the tube to fenestrate it. And you can see here, there's a nice little trickle from the tube. OK, so the tube is in place. So we're just going to start closing up now. OK, so we're all done. [MUSIC PLAYING]