Posters

Step-by-step surgical technique for closure of dehisced conjunctiva in a patient with glaucoma drainage device (GDD)

Poster Details

First Author: A. Ivanescu UNITED KINGDOM

Co Author(s):    D. Mathews                    

Abstract Details

Purpose:

To describe a step by step surgical technique by using combined tutoplast, conjunctival autograft and amniotic membrane to close a dehisced conjunctiva in a patient with GDD.

Setting:

Stanley Eye Unit, Abergele Hospital, UK

Methods:

Patient with previous history of herpetic kerato uveitis and Baerveldt tube developed dehiscence of conjunctiva over the Baerveldt plate. He had previous surgical interventions on two occasions, which consisted of direct closure of the conjunctiva and conjunctival autograft respectively, with no success. In order to close the persistent defect, at 7 weeks, he underwent additional surgery in the form of relieving conjunctival incisions, tutoplast, conjunctival autograft and amniotic membrane to ensure closure of defect and healing.

Results:

To close the defect, our patient required a tutoplast patch graft over the exposed ridge and plate sutured to the sclera, followed by a conjunctiva autograft from the inferior conjunctiva of the same eye over the tutoplast graft and finally, an amniotic membrane overlay sutured to the conjunctiva. There were no intraoperative or postoperative complications.

Conclusions:

Tube/plate erosions are a very challenging problem to manage, especially in eyes that have undergone several surgical interventions. As demonstrated here, tutoplast, conjunctival autograft and amniotic membrane can be used in conjunction, in situations where conjunctival scarring otherwise preclude successful repair.

Financial Disclosure:

NONE