Amniotic membrane graft to patch an overfiltering trabeculectomy flap
Purpose: To describe the use of an amniotic membrane graft (AMG) with fibrin sealant to address an overfiltering trabeculectomy flap encountered intraoperatively. Observations: A 35-year-old female with severe primary open angle glaucoma underwent trabeculectomy with mitomycin C due to uncontrolled...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-12-01
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| Series: | American Journal of Ophthalmology Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451993624001385 |
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| author | Michael C. Yang Michelle T. Sun Wendy W. Liu |
| author_facet | Michael C. Yang Michelle T. Sun Wendy W. Liu |
| author_sort | Michael C. Yang |
| collection | DOAJ |
| description | Purpose: To describe the use of an amniotic membrane graft (AMG) with fibrin sealant to address an overfiltering trabeculectomy flap encountered intraoperatively. Observations: A 35-year-old female with severe primary open angle glaucoma underwent trabeculectomy with mitomycin C due to uncontrolled intraocular pressure (IOP). Intraoperatively, the elastic nature of the scleral flap led to overfiltration, causing persistent anterior chamber shallowing despite numerous sutures. To decrease but not completely shut down aqueous outflow through the trabeculectomy flap, we utilized AMG and fibrin sealant to stabilize the flap. Postoperatively, the patient had a formed anterior chamber, elevated bleb and significantly reduced IOP, without the need for additional glaucoma medications. Conclusions and importance: Amniotic membrane grafts (AMG) with fibrin sealant may help regulate aqueous flow efflux, maintain anterior chamber stability, and mitigate the risk of postoperative hypotony in trabeculectomy surgery. AMG was chosen in this setting given its anti-inflammatory, anti-fibrotic properties, as well as its optically clear nature to allow for post-operative visualization of the flap. AMG allows for early postoperative stabilization of the scleral flap without complete obstruction, and may be useful in patients at risk of early postoperative hypotony. |
| format | Article |
| id | doaj-art-3ecc644d76b542a092dfc2a97206b55e |
| institution | OA Journals |
| issn | 2451-9936 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Ophthalmology Case Reports |
| spelling | doaj-art-3ecc644d76b542a092dfc2a97206b55e2025-08-20T01:57:51ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362024-12-013610212810.1016/j.ajoc.2024.102128Amniotic membrane graft to patch an overfiltering trabeculectomy flapMichael C. Yang0Michelle T. Sun1Wendy W. Liu2Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USAByers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USACorresponding author. Spencer Center for Vision Research, 2370 Watson Court, Palo Alto, CA, 94303, USA.; Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USAPurpose: To describe the use of an amniotic membrane graft (AMG) with fibrin sealant to address an overfiltering trabeculectomy flap encountered intraoperatively. Observations: A 35-year-old female with severe primary open angle glaucoma underwent trabeculectomy with mitomycin C due to uncontrolled intraocular pressure (IOP). Intraoperatively, the elastic nature of the scleral flap led to overfiltration, causing persistent anterior chamber shallowing despite numerous sutures. To decrease but not completely shut down aqueous outflow through the trabeculectomy flap, we utilized AMG and fibrin sealant to stabilize the flap. Postoperatively, the patient had a formed anterior chamber, elevated bleb and significantly reduced IOP, without the need for additional glaucoma medications. Conclusions and importance: Amniotic membrane grafts (AMG) with fibrin sealant may help regulate aqueous flow efflux, maintain anterior chamber stability, and mitigate the risk of postoperative hypotony in trabeculectomy surgery. AMG was chosen in this setting given its anti-inflammatory, anti-fibrotic properties, as well as its optically clear nature to allow for post-operative visualization of the flap. AMG allows for early postoperative stabilization of the scleral flap without complete obstruction, and may be useful in patients at risk of early postoperative hypotony.http://www.sciencedirect.com/science/article/pii/S2451993624001385Amniotic membrane graftOverfiltering blebTrabeculectomyHypotonyScleral flapFibrin glue |
| spellingShingle | Michael C. Yang Michelle T. Sun Wendy W. Liu Amniotic membrane graft to patch an overfiltering trabeculectomy flap American Journal of Ophthalmology Case Reports Amniotic membrane graft Overfiltering bleb Trabeculectomy Hypotony Scleral flap Fibrin glue |
| title | Amniotic membrane graft to patch an overfiltering trabeculectomy flap |
| title_full | Amniotic membrane graft to patch an overfiltering trabeculectomy flap |
| title_fullStr | Amniotic membrane graft to patch an overfiltering trabeculectomy flap |
| title_full_unstemmed | Amniotic membrane graft to patch an overfiltering trabeculectomy flap |
| title_short | Amniotic membrane graft to patch an overfiltering trabeculectomy flap |
| title_sort | amniotic membrane graft to patch an overfiltering trabeculectomy flap |
| topic | Amniotic membrane graft Overfiltering bleb Trabeculectomy Hypotony Scleral flap Fibrin glue |
| url | http://www.sciencedirect.com/science/article/pii/S2451993624001385 |
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