Comparison of single thickness and double thickness processed pericardium patch graft in glaucoma drainage device surgery: a single surgeon comparison of outcome.
OBJECTIVE
To compare the incidence of conjuctival erosions with single thickness versus double thickness allograft processed pericardium used in mitomycin-C (MMC) augmented glaucoma drainage device (GDD) sugery.


METHODS
In a retrospective comparative case series, medical records of 84 consecutive glaucoma patients who underwent GDD surgery between July 1996 to December 2004 were reviewed. All surgeries were done by one glaucoma surgeon (M.R.M.). MMC was adminstered in all cases over the plate area and either single thickness processed pericardium patch graft (STPP) or double thickness processed pericardium patch graft (DTPP) was used to cover the external silicone tube of the glaucoma device at the limbus. The principal outcome measure was the incidence of conjunctival erosions associated with GDD surgery.


RESULTS
Eighty-four patients (90 eyes) who met the eligibility criteria were enrolled in the study. Thirty-one consecutive eyes received a STPP, and 59 consecutive eyes received a DTPP. Five eyes (16.0%) in the STPP group developed conjunctival erosion. None of the eyes in DTPP group developed conjunctival erosion. The Mann-Whitney U test difference in the rate of conjunctival erosion was statistically significant between 2 groups (P=0.002). For the STPP group, the average time to conjunctival erosion was 9 months (range, 4 to 14 mo). All erosions were surgically corrected using DTPP and followed up for a mean of 8.6 months after repair with no additional conjunctival erosions.


CONCLUSIONS
DTPP placed over the silicone tube significantly reduced the incidence of conjunctival erosion after MMC augmented GDD surgery.
Lankaranian
Dara
D
William and Anna Goldberg Glaucoma Service, Wills Eye Hospital, Jefferson Medical College, Department of Ophthalmology, Temple University, Philadelphia, PA 19107, USA.
Reis
Ricardo
R
Henderer
Jeffrey D
JD
Choe
Sung
S
Moster
Marlene R
MR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000477:Alkylating Agents / Q000008:administration & dosage; D001684:Biological Dressings; D005260:Female; D005901:Glaucoma / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D010496:Pericardium / Q000637:transplantation*; D011183:Postoperative Complications; D019919:Prosthesis Implantation / Q000379:methods*; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D016896:Treatment Outcome
D000477:Alkylating Agents; D016685:Mitomycin