Buccal mucous membrane for the reconstruction of complicated leaking trabeculectomy blebs

J Glaucoma. Apr-May 2010;19(4):270-4. doi: 10.1097/IJG.0b013e3181aff448.

Abstract

Purpose: Late onset trabeculectomy bleb leaks often require surgical repair to avoid hypotony and/or infection. Repair using local conjunctiva is typically performed. However, in cases in which local conjunctiva is limited and/or has failed, buccal mucous membrane can be used as a conjunctival substitute.

Methods: Four cases of buccal mucous membrane repair for leaking trabeculectomy blebs are reported. Surgical technique is described.

Results: In each case of bleb leak, multiple nonincisional techniques failed to control the leak. In 3 of 4 cases, earlier reconstruction attempts with conjunctival advancement and/or free flaps failed. Each was ultimately repaired with buccal membrane autograft. One case required additional minimally invasive procedures to control postoperative leaking. One case required a second adjacent buccal graft for leaking residual conjunctival bleb. Each graft was functioning well at most recent follow-up ranging from 1 to 17 months.

Discussion: Buccal membrane is an abundant and effective conjunctival substitute for the repair of recalcitrant leaking trabeculectomy blebs. It may be useful in cases in which earlier conjunctival-based repairs have failed.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Blister / metabolism*
  • Blister / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Minimally Invasive Surgical Procedures
  • Mouth Mucosa / transplantation*
  • Reconstructive Surgical Procedures*
  • Reoperation
  • Trabeculectomy / adverse effects*
  • Transplantation, Autologous