title: Repair of eroded glaucoma drainage devices: mid-term outcomes.
abstract: OBJECTIVE
  Glaucoma drainage devices (GDD) are used in the surgical management of medically refractory glaucoma. One late serious complication is erosion and exposure of the tube, clip, or plate. In this study, we evaluated the effectiveness of oral buccal mucous membrane allografts with corneal lamellar grafts for the repair of GDD erosions.
  
  
  METHODS
  Retrospective consecutive observational case series. All patients who underwent buccal membrane transplants with corneal allografts for the repair of GDD erosions between 2006 and 2010 were included in this study. Primary outcomes were categorized as: (a) success: coverage of the GDD without further repair; (b) qualified success: minor perioperative complications or additional procedures required to maintain success; or (c) failure: GDD reerosion requiring surgery.
  
  
  RESULTS
  Nineteen eyes from 17 patients with 20 GDDs were reviewed, of which there were 19 Ahmed valves and 1 Molteno implant. There were 16 cases of tube erosion, 2 cases of plate erosion, and 2 cases of pars plana clip erosion. The mean (SD) number of ocular surgeries before the buccal membrane transplant was 4.8 (2.9). The mean (SD) time to exposure from the original GDD procedure was 4.6 (3.7) years. Analysis of tube erosions alone showed a success rate of 94% after ≥ 1 buccal membrane repairs. Buccal membrane repairs in total were considered a surgical success in 85% of cases with a mean (SD) follow-up of 1.7 (1.2) years.
  
  
  CONCLUSIONS
  Buccal membrane transplants are particularly useful in cases of tube erosion.
authors: Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, ON, Canada. stephanie.low@utoronto.ca
authors: Stephanie A W
authors: SA
authors: Low
authors: Dan B
authors: DB
authors: Rootman
authors: David S
authors: DS
authors: Rootman
authors: Graham E
authors: GE
authors: Trope
mesh_terms: D016039:Corneal Transplantation; D005260:Female; D005901:Glaucoma / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D006801:Humans; D008297:Male; D008875:Middle Aged; D009055:Mouth; D009061:Mouth Mucosa / Q000637:transplantation*; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000601:surgery*; D014184:Transplantation, Homologous; D014945:Wound Healing