Subconjunctival placement of human amniotic membrane during high risk glaucoma filtration surgery

To determine whether subconjunctival placement of amniotic membrane improves filtration results in patients with glaucoma at high risk for surgical failure.

Retrospective review of 17 eyes of 15 patients who had amniotic membrane applied during glaucoma surgery with or without mitomycin C or 5-fluorouracil.

Mean intraocular pressure decreased from 27.0 +/- 9.1 mm Hg preoperatively to 18.1 +/- 11.0 mm Hg postoperatively with a mean follow-up of 179 days. Complications included self-limited conjunctival wound dehiscence (n = 5), uveitis recurrence (n = 2), and cataract progression (n = 1).

The results suggest that subconjunctival placement of amniotic membrane may improve filtration outcome in high risk eyes. It will be of interest to determine whether the anti-inflammatory, anti-angiogenic, and antifibrotic properties of amniotic membrane placed subconjunctivally and under the scleral flap will improve filtration surgery outcome by a prospective, randomized study.