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Combination of Microstereolithography and Electrospinning to Produce Membranes Equipped with Niches for Corneal Regeneration

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Amniotic membrane graft to patch an overfiltering trabeculectomy flap.

Michael C Yang¹, Michelle T Sun¹, Wendy W Liu¹

¹Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA.

American Journal of Ophthalmology Case Reports

|August 14, 2024

Summary

An amniotic membrane graft (AMG) with fibrin sealant effectively managed an overfiltering trabeculectomy flap, stabilizing the anterior chamber and reducing intraocular pressure post-surgery. This technique offers a novel approach to prevent hypotony after glaucoma surgery.

Keywords:

Amniotic membrane graft Fibrin glue Hypotony Overfiltering bleb Scleral flap Trabeculectomy

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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.