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H. Sheha, B. Francis; A Novel Use of Amniotic Membrane to Prevent Glaucoma Shunt Tube Exposure. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4421.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the feasibility of using amniotic membrane patch graft (AMG) to prevent tube exposure after glaucoma drainage device (GDD) implantation.
This pilot study was conducted on 10 eyes of 10 consecutive patients undergoing GDD implantation. A commercially available 300 µ-thick AMG (10 x 7.5 mm) was secured over the extraocular portion of the tube using four interrupted 10-0 nylon sutures. Patients were monitored clinically for signs of tube related inflammation, infection or exposure. Further evaluation of the fate of AMG was performed by the Visante OCTTM at 1, 3 and 6 months.
AMG was easy to handle during surgery. Over a mean follow up period of 8 months (range, 3-13 months) AMG provided the required tectonic support and remained stable. Sequential anterior segment OCT images showed changes in reflectivity suggesting host cell integration into the graft. The membrane was translucent enough to allow laser suturelysis, which was required in 3 eyes. No graft related infection or tube exposures were identified.
Compared to historical clinical experience using existing patch grafts, a thicker version of AMG offers superior tectonic support and biological activity to promote integration by the host conjunctival stroma, thus ameliorating the patch graft thinning/erosion. This result justifies long-term, controlled studies with a larger sample size.
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