title: Outcomes of using a sutureless bovine pericardial patch graft for Ahmed glaucoma valve implantation.
abstract: OBJECTIVE
  To evaluate the long-term outcomes of a surgical technique using a sutureless bovine pericardial patch graft for the implantation of an Ahmed glaucoma valve (AGV).
  
  
  METHODS
  This was a pilot study on patients with primary open-angle glaucoma refractory to repeated surgical filtering procedures. All patients underwent AGV implant technique using a sutureless bovine pericardial patch graft. The pericardial membrane was cut using an ordinary corneal trephine with a diameter of 9.0 or 10.0 mm. The anterior part of the tube was covered with the graft and kept in place with fibrin glue. Subsequently, the cap was stitched all around the tube and the dissected conjunctiva was laid over it. Intraocular pressure (IOP) and complications were evaluated 1 week and 1, 3, 6, 12, and 24 months after surgery.
  
  
  RESULTS
  The procedure was used to treat 20 eyes of 20 consecutive patients (12 men and 8 women: mean age [SD] 64.8 [7.8] years). Mean IOP was 28.1 mm Hg (SD 4.9) at baseline and decreased to 14.9 mm Hg (SD 1.5) 24 months after surgery (p<0.001). The overall mean number of topical medications was 3.1 (SD 0.5) at baseline and decreased to 1.4 (SD 0.8) after 24 months (p<0.001). During follow-up, there was no conjunctival erosion, thinning of pericardial patch graft over the tube, or tube exposure; no signs of endophthalmitis were recorded.
  
  
  CONCLUSIONS
  The results suggest that the sutureless technique using a bovine pericardial graft patch is a safe and rapid procedure for AGV implantation.
authors.affiliation: Ophthalmology Department, University of Brescia, Brescia, Italy. quaranta@med.unibs.it
authors.forename: Luciano
authors.initials: L
authors.lastname: Quaranta
authors.forename: Ivano
authors.initials: I
authors.lastname: Riva
authors.forename: Irene C
authors.initials: IC
authors.lastname: Floriani
mesh_terms: D000368:Aged; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D020327:Glaucoma Drainage Implants; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000637:transplantation*; D010865:Pilot Projects; D011183:Postoperative Complications; D013536:Suture Techniques
chemical_list: D015718:Fibrin Tissue Adhesive