Glaucoma aqueous drainage device erosion repair with buccal mucous membrane grafts

J Glaucoma. Oct-Nov 2009;18(8):618-22. doi: 10.1097/IJG.0b013e318193c472.

Abstract

Purpose: Glaucoma aqueous drainage devices are important and effective in the management of recalcitrant glaucoma. One complication of this procedure is erosion and exposure of the tube or plate. Strategies to re-cover glaucoma aqueous drainage devices in such cases have met with variable success. The majority of these interventions use conjunctiva for superficial coverage. However, conjunctiva can be in limited supply, and subject to reerosion.

Methods: In this report, we discuss the use of oral buccal mucous membrane in combination with a lamellar corneal patch graft for repair of 3 exposed tubes, 2 plates, and a pars plana clip. Mean time to exposure was 4.8 years. Five eyes from 4 patients are presented and the surgical technique is described.

Results: Buccal membrane repairs were considered a surgical success in 5 out of 6 cases (83%) with mean follow-up of 1.5 years.

Conclusions: We advocate the use of buccal membrane in the repair of glaucoma aqueous drainage device tube/plate erosions in patients for whom local conjunctiva is of variable quality or limited supply. Advantages of this procedure and tissue option are discussed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cheek*
  • Corneal Transplantation*
  • Equipment Failure
  • Female
  • Follow-Up Studies
  • Glaucoma / surgery*
  • Glaucoma Drainage Implants / adverse effects*
  • Humans
  • Male
  • Middle Aged
  • Mucous Membrane / transplantation*
  • Reoperation
  • Retrospective Studies
  • Treatment Outcome