Abstract
Background
To report long-term results of amniotic membrane transplantation (AMT)-assisted bleb revision for intractable late-onset bleb leak.
Methods
Retrospective medical record review of six consecutive patients who underwent AMT-assisted bleb revision for late-onset bleb leak at the Kobe University hospital between December 2001 and March 2004.
Results
The median (range) of age was 60 (20–77) years. All patients had a history of trabeculectomy with adjunctive use of 0.4 mg/ml mitomycin C. The median (range) of interval between the prior trabeculectomy and bleb leak was 15 (4–54) months. Preoperative intraocular pressure (IOP) was lower than 10 mmHg in two cases, while it was 25 mmHg or higher in three patients, who had a localized, ischemic, thin-wall leaking bleb circumscribed with extensively scarred tissue. The median (range) of follow-up after the AMT-assisted bleb revision was 49 (41–67) months. Postoperative IOP was well controlled in all patients without medication or with a maximum of three glaucoma medications. No patients presented recurrence of the bleb leak or AMT-related complications during entire follow-up. All patients showed at final visit a diffuse bleb which extended posteriorly beyond the conjunctival incision line.
Conclusion
AMT-assisted bleb revision successfully treated intractable late-onset bleb leak. Further comparative studies are needed to confirm the present result.
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Financial support: This study was supported in part by Grant-in-Aid No. 16390499 (AN, MN) and No. 17591835 (MN) from the Ministry of Education, Culture, Sports, Science and Technology of the Japanese Government and by Suda Memorial Foundation for Glaucoma Research (MN). MN is a recipient of the 12th ROHTO award for Ophthalmic Research.
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Nagai-Kusuhara, A., Nakamura, M., Fujioka, M. et al. Long-term results of amniotic membrane transplantation-assisted bleb revision for leaking blebs. Graefes Arch Clin Exp Ophthalmol 246, 567–571 (2008). https://doi.org/10.1007/s00417-007-0727-x
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DOI: https://doi.org/10.1007/s00417-007-0727-x