Sutureless human sclera donor patch graft for Ahmed glaucoma valve.
OBJECTIVE
To report the safety and effectiveness of a sutureless human sclera donor patch graft covering the subconjunctival portion of glaucoma drainage implant tube to prevent its erosion throughout the overlying conjunctiva.


METHODS
This was a prospective pilot study. Fifteen eyes of 15 consecutive patients not responsive to medical and to not-implant surgical glaucoma treatment underwent Ahmed glaucoma valve (AGV) implant surgery with sutureless human sclera donor patch graft. The surgical procedure included AVG implant placed 8 mm behind the corneal limbus and fixed to the sclera with two 9-0 black nylon sutures. The tube was passed through the scleral tunnel, parallel to the corneal limbus, and shortened at the desired length. The anterior part of the tube was covered with human donor scleral graft and kept in place with fibrin glue (Tissue Coll) under the conjunctiva. Examinations were scheduled at baseline and then at 1 week and 1, 3, 6, and 12 months after surgery.


RESULTS
At 12-month follow-up, the best-corrected visual acuity did not significantly improve from baseline 0.78+/-1.2 logMAR, whereas mean intraocular pressure significantly decreased from preoperative values of 29.8 (SD 8.4) mmHg. In all cases, the scleral patch was found in place at each check during the follow-up period. No conjunctival erosion over the AGV tube nor sign of endophthalmitis was recorded at any time during the follow-up period.


CONCLUSIONS
AVG implant surgery with sutureless human sclera donor patch graft represents an effective and relatively safe surgical procedure for complicated glaucomas, avoiding conjunctival erosions over the AGV tube.
Zeppa
Lucio
L
Unità Operativa di Oculistica, Presidio Ospedaliero Giuseppe Moscati, Avellino - Italy.
Romano
Mario R
MR
Capasso
Luigi
L
Tortori
Achille
A
Majorana
Mara A
MA
Costagliola
Ciro
C
D000328:Adult; D000368:Aged; D003228:Conjunctiva / Q000601:surgery*; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D005500:Follow-Up Studies; D005901:Glaucoma / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D019919:Prosthesis Implantation / Q000379:methods*; D012590:Sclera / Q000637:transplantation*; D013536:Suture Techniques; D014014:Tissue Adhesives / Q000627:therapeutic use; D014019:Tissue Donors; D014792:Visual Acuity / Q000502:physiology
D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives