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Amniotic membrane transplantation in failed trabeculectomy.

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  • 1*Department of Ophthalmology, Misericordia Hospital, Grosseto †Department of Ophthalmology, University of Siena, Siena ‡DICeM, Department of Civil and Mechanical Engineering, University of Cassino and Southern Lazio-Italy, Cassino, Italy.

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Amniotic membrane transplantation significantly improved trabeculectomy success in patients with prior failed glaucoma surgery. This safe procedure effectively lowered intraocular pressure and maintained bleb function long-term.

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Area of Science:

  • Ophthalmology
  • Glaucoma Surgery
  • Tissue Transplantation

Background:

  • Trabeculectomy is a common glaucoma surgery.
  • Previous filtering bleb failure increases surgical risk.
  • Alternative strategies are needed for refractory glaucoma.

Purpose of the Study:

  • To evaluate amniotic membrane transplantation efficacy for trabeculectomy in patients with failed filtering blebs.
  • To assess the safety and long-term outcomes of this combined procedure.

Main Methods:

  • Retrospective study of 19 eyes from 18 patients with failed trabeculectomies.
  • Amniotic membrane used as a graft under the scleral flap during revision trabeculectomy.
  • Analysis of intraocular pressure (IOP), medication use, bleb appearance, and complications over 24 months.

Main Results:

  • Success (IOP < 21 mm Hg) achieved in 100% of cases at 24 months.
  • Median IOP reduced from 29 mm Hg preoperatively to 19 mm Hg postoperatively.
  • 95% of filtering blebs remained functional without medication at 24 months.
  • No severe intraoperative or postoperative complications reported.

Conclusions:

  • Amniotic membrane transplantation is a safe and effective adjunct to trabeculectomy in high-risk patients.
  • This procedure improves surgical outcomes and maintains low intraocular pressure.
  • It offers a viable solution for patients with recurrent glaucoma filtering bleb failure.