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V. Fernandez Gensini, G. P. Schwartz, G. Gregory, J.-M. A. Parel, F. Fantes; The Wse of Corneal Patch Grafts in Glaucoma Tube Shunt Surgery at Bascom Palmer Eye Institute. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1249.
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To determine the safety and effectiveness of corneal patch grafts in glaucoma tube shunt surgery.
A retrospective chart review was conducted at the Bascom Palmer Eye Institute on a group of patients who underwent a glaucoma drainage implant procedure with the use of a glycerin-preserved corneal patch graft. Charts were assessed for evidence of tube exposure, infection, graft rejection, graft thinning, dellen formation, and conjunctival retraction.
One-Hundred-fifty-nine eyes were enrolled. Mean follow-up was 14 ± 9.1 months (range, 9 to 43 months). Five of the 159 eyes (3.14%) were noted to have tube exposure but only in 2 eyes (1.26%) the exposure was in the area where the patch graft was placed. The mean number of months to the exposure was 5.6 ± 6.4 months (range, 1 to 17 months). Five of the eyes were noted to have asymptomatic thinning of the corneal patch. Mean length to thinning of the patch graft was 6.0 ± 2.1 months (range, 3 to 8 months). There were no cases of infection, dellen formation, or conjunctival retraction in the 159 eyes. All cornea patch graft remained transparent and healthy at the latest follow up.
The use of corneal donor tissue for patch grafts in glaucoma tube shunt surgery is safe and effective. Because the cornea is transparent, it allows visualization of the ligature and facilitates laser suture lysis. The appearance is cosmetically pleasing, especially in inferiorly placed tube shunts. Donor cornea may be the most readily available tissue, and with the advent of DSAEK Cap, it is now possible to obtain, from one donor cornea, enough tissue for 2 procedures: cornea transplant and glaucoma tube shunt surgery.Support: Florida Lions Eye Bank; NIH Center Grant P30EY14801; an unrestricted grant from Research to Prevent Blindness; the Henri and Flore Lesieur Foundation.
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