Abstract
Purpose :
To present a series of eight patients who underwent revision surgery for exposed glaucoma tube shunts due to late conjunctival defects using a biodegradable collagen glycosaminoglycan matrix (CGM, ologen).
Methods :
Due to the small number of patients with conjunctival erosion on top of glaucoma tube shunts we present a series of 8 patients between 2010 and 2015. In every case tubes became exposed through necrosis of the overlying sclera and/or conjunctiva more than three months postoperatively. The eroded conjunctiva was then repaired by lateralization and new fixation of the tube to surface of the sclera, a customized CGM as a patch and cover by adjacent conjunctiva. Follow-up was performed prospectively over a period of minimum one year after surgery.
Results :
In this threatening but fortunately rare condition after drainage device surgery we were able to achieve prolonged wound closure in all cases. Side effects or complications with respect to the revision surgery were not observed. Due to the complex situations in 50 % of the patients further glaucoma surgery was necessary for IOP control, however, this was not in direct connection to the CGM patch surgery.
Conclusions :
Erosion of the conjunctiva above a drainage tube following shunt surgery is a potentially serious problem. It can be successfully managed by lateral displacement and using CGM as a patch before closing the conjunctiva.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.