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Frederick M Kapetansky; Use of Split-thickness Dermis Grafts to Repair Eroding Aqueous Drainage Tube Shunts. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6494.
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The erosion of aqueous drainage tube shunts continue to represent a significant long-term complication of this procedure because of the risk of developing endophthalmitis. We employed an autologous split-thickness dermis graft to cover the eroding tube.
This is a retrospective study of five eyes in which an autologous split-thickness dermis graft was harvested from the patient's upper thigh to be used for a patch graft. The tube had been exposed as a result of the erosion of the overlying comjunctiva and the previously placed pericardial patch graft. The dermis graft was trimmed so that it was approximately 30% larger than the exposed area to be covered. The outer edges of the graft were tucked under the surrounding healthy conjunctiva,and sutured in place with multiple 10o nylon sutures. Topical antibiotic drops were used QID for four weeks following this procedure.
The first patient to have this surgical repair was in 1999. The subsequent four patients had their repair operation performed between the years 2000 and 2014. All the eyes had a minimum of 12 months follow-up. None of the eyes required further surgical treatment for the erosion during the ensuing years following the repair. None of the eyes showed signs of rejection of the dermis graft, and none of the eyes had evidence of infection that could be attributed to the placement of the dermis graft. Either a Baerveldt tube shunt or Molteno tube shunt was used in all the eyes.
Split-thickness dermis grafts appear to be a reasonable option for the repair of an eroding aqueous drainage tube shunt. We theorize that our success with split-thickness dermis grafts may be attributed to the fact that the graft tissue has it own blood supply. This is in contrast to our experience using other available patch graft material.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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