Use of amniotic membrane graft in glaucoma shunt surgery

■ BACKGROUND AND OBJECTIVE: To determine the safety and efficacy of amniotic membrane graft in glaucoma drainage device surgery. ■ PATIENTS AND METHODS: Institutional retrospective case series of 44 patients undergoing glaucoma drainage device implantation with use of 300-μm thick amniotic membrane as a patch graft. Endpoints assessed were tube exposure, graft thinning, graft clarity, graft-related infection, and inflammation. ■ RESULTS: A total of 41 (93%) eyes had an uneventful course over a mean follow-up of 22 ± 3 months (range: 17 to 28 months). Tube exposure and hypotony each occurred in one eye and were successfully treated with a tube revision using double pericardial and amniotic membrane patch graft. The translucency of amniotic membrane graft enabled good visualization of the occluding suture when performing laser suture lysis in 16 eyes. Sequential anterior segment optical coherence tomography showed stable amniotic membrane graft thickness with a change from low to moderate reflectivity in the subconjunctival - graft bilayer. ■ CONCLUSION: Amniotic membrane graft offers good tectonic support and allows direct visualization of the underlying tube.