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Epithelial ingrowth and glaucoma drainage implants

P A Sidoti1, D S Minckler, G Baerveldt

  • 1Department of Ophthalmology, University of Southern California School of Medicine, Los Angeles.

Ophthalmology
|May 1, 1994
PubMed
Summary
This summary is machine-generated.

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Conjunctival epithelial invasion after glaucoma implant surgery, especially with prior scleral buckling, can cause wound leaks. Surgical revision with debridement and cautery successfully managed these complications.

Area of Science:

  • Ophthalmology
  • Glaucoma Surgery
  • Ophthalmic Pathology

Background:

  • Reports four cases of conjunctival epithelial invasion into the fibrous capsule of Baerveldt glaucoma implants.
  • All cases were associated with concurrent or prior scleral buckling surgery.

Observation:

  • Three patients experienced postoperative conjunctival wound leaks at varying times.
  • A fourth patient developed a fistulous tract over the implant.
  • Histopathologic confirmation of subconjunctival epithelialization was achieved in two cases.

Findings:

  • Surgical revision was performed in all patients, involving epithelial debridement, cautery, and wound closure.
  • Implant removal was necessary in one case.
  • No recurrent wound leaks or adverse sequelae were observed post-revision.

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Implications:

  • Epithelial invasion can lead to conjunctival wound breakdown and persistent aqueous leaks after glaucoma drainage device implantation.
  • Scleral buckling surgery may increase the risk of this complication.
  • Surgical revision techniques, including debridement and cautery, are effective in managing epithelial invasion and wound leaks.