Amniotic membrane transplantation in failed trabeculectomy

Session Details

Session Title: Glaucoma II

Session Date/Time: Monday 15/09/2014 | 08:00-10:30

Paper Time: 10:16

Venue: Boulevard F (Level 1)

First Author: : V.Sarnicola ITALY

Co Author(s): :    M. Chiara   P. Toro Ibanez   C. Sarnicola   E. Sarnicola   A. Ruggiero  

Abstract Details

Purpose:

To determine the efficacy and safety of amniotic membrane transplantation for trabeculectomy in patients with previous failed filtering blebs.

Setting:

Misericordia Hospital, Grosseto, Italy

Methods:

A consecutive series of 19 eyes from 18 patients with one or more failed trabeculectomies were enrolled in this retrospective study. Trabeculectomy, with amniotic membrane positioned as a 'graft' under the scleral flap, was performed, and the intraocular pressure (IOP), number of anti-glaucoma medications, appearance of the filtering bleb, and intra- and postoperative complication data were retrospectively analyzed for a period of 24 months. Success was defined as IOP <21 mm Hg at the end of the follow-up period.

Results:

The median preoperative pressure was 29mm Hg (IQR=5 mm Hg), with an average of 2.8 glaucoma medications (range 1-4). At 6 months postoperative the median IOP was 18mm Hg (IQR=1.75 mm Hg) with no further significant increases recorded, settling at 19mm Hg (IQR=3.25 mm Hg) at the end of the 24-month follow-up. Success was achieved in all 19 cases (100%). Only one patient (5%) required postoperative anti-glaucoma therapy to reach the target pressure. At 24 months after surgery, 18 of 19 (95%) amniotic membrane filtering blebs were functioning well without anti-glaucoma therapy. No patients had severe intra- or postoperative complications.

Conclusions:

Amniotic membrane transplantation in trabeculectomy seems to be a safe and useful procedure for improving the surgical outcome and maintaining low postoperative IOP in patients with a high risk of surgical failure.

Financial Interest:

NONE