Amniotic membrane graft to patch an overfiltering trabeculectomy flap

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Tissue Engineering

Background:

• Trabeculectomy is a common glaucoma surgery to reduce intraocular pressure.
• Overfiltration of aqueous humor can lead to complications such as anterior chamber shallowing and hypotony.
• Managing overfiltering flaps intraoperatively is crucial for successful surgical outcomes.

Observation:

• A case of severe primary open-angle glaucoma treated with trabeculectomy experienced intraoperative flap overfiltration.
• An amniotic membrane graft (AMG) combined with fibrin sealant was applied to modulate aqueous outflow.
• The patient achieved a stable anterior chamber, elevated bleb, and reduced intraocular pressure post-procedure.

Findings:

• The use of AMG and fibrin sealant successfully stabilized the overfiltering trabeculectomy flap.
• This intervention regulated aqueous outflow without completely obstructing it.
• The patient's intraocular pressure was significantly reduced, eliminating the need for additional glaucoma medications.

Implications:

• Amniotic membrane grafts with fibrin sealant represent a promising method for managing overfiltering trabeculectomy flaps.
• This technique may help maintain anterior chamber stability and prevent postoperative hypotony.
• AMG's anti-inflammatory and anti-fibrotic properties, along with optical clarity, make it suitable for this application.