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1 General aspects (0)   1.1 Epidemiology (16)   1.2 Population genetics (1)   1.3 Pathogenesis (1)   1.4 Quality of life (10)   1.5 Glaucomas as cause of blindness (4)   1.6 Prevention and screening (7) 2 Anatomical structures in glaucoma (0)   2.1 Conjunctiva (7)   2.2 Cornea (18)   2.3 Sclera (7)   2.4 Anterior chamber angle (1)   2.5 Meshwork (0)     2.5.1 Trabecular meshwork (4)     2.5.2 Schlemms canal (1)     2.5.3 Scleral outlet channels (1)   2.6 Aqueous humor dynamics (0)     2.6.1 Production (2)     2.6.2 Outflow (2)       2.6.2.1 Trabecular meshwork (7)       2.6.2.2 Uveoscleral (0)     2.6.3 Compostion (2)   2.7 Episcleral veins and venous pressure (1)   2.8 Iris (5)   2.9 Ciliary body (1)   2.10 Lens (1)   2.11 Vitreous body (0)   2.12 Choroid, peripapillary choroid, peripapillary atrophy (1)   2.13 Retina and retinal nerve fibre layer (20)   2.14 Optic disc (13)   2.15 Optic nerve (3)   2.16 Chiasma and retrochiasmal central nervous system (5)   2.17 Stem cells (1)   2.20 Other (0) 3 Laboratory methods (0)   3.1 Microscopy (2)   3.2 Electron microscopy (2)   3.3 Immunohistochemistry (3)   3.4 Molecular genetics (0)     3.4.1 Linkage studies (0)     3.4.2 Gene studies (13)   3.5 Molecular biology incl. 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Anterior segment (1)     6.3.2 Posterior segment (3)   6.4 Gonioscopy (1)   6.5 Ophthalmoscopy (0)   6.6 Visual field examination and other visual function tests (0)     6.6.1 Conventional manual (0)     6.6.2 Automated (19)     6.6.3 Special methods (e.g. color, contrast, SWAP etc.) (11)   6.7 Electro-ophthalmodiagnosis (3)   6.8 Photography (0)     6.8.1 Anterior segment (1)     6.8.2 Posterior segment (5)   6.9 Computerized image analysis (0)     6.9.1 Laser scanning (0)       6.9.1.1 Confocal Scanning Laser Ophthalmoscopy (13)       6.9.1.2 Confocal Scanning Laser Polarimetry (8)     6.9.2 Optical coherence tomography (0)       6.9.2.1 Anterior (8)       6.9.2.2 Posterior (28)     6.9.5 Other (3)   6.10 Fluorescein (ICG) angiography (0)     6.10.1 Anterior segment (0)     6.10.2 Posterior segment (1)   6.11 Bloodflow measurements (24)   6.12 Ultrasonography and ultrasound biomicroscopy (7)   6.13 Provocative tests (2)   6.19 Telemedicine (2)   6.20 Progression (9)   6.30 Other (1) 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(0)     9.4.1 Steroid-induced glaucoma (9)     9.4.2 Glaucomas associated with disorders of the cornea, conjunctiva, sclera (0)       9.4.2.1 Iridocorneal endothelial syndrome (ICE, incl. irisatrophy) (3)       9.4.2.2 Posterior polymorphous dystrophy (0)       9.4.2.3 Fuchs' endothelial dystrophy (0)       9.4.2.5 Other (0)     9.4.3 Glaucomas associated with disorders of the iris and ciliary body (0)       9.4.3.1 Pigmentary glaucoma (3)       9.4.3.5 Other (0)     9.4.4 Glaucomas associated with disorders of the lens (0)       9.4.4.1 Exfoliation syndrome (15)       9.4.4.2 Glaucomas associated with cataracts (0)       9.4.4.3 Glaucomas associated with lens dislocation (1)       9.4.4.5 Other (1)     9.4.5 Glaucomas associated with disorders of the retina, choroid and vitreous (2)       9.4.5.1 Neovascular glaucoma (6)       9.4.5.5 Other (2)     9.4.6 Glaucomas associated with inflammation, uveitis (4)     9.4.7 Glaucomas associated with ocular trauma (3)     9.4.8 Glaucomas associated with intraocular tumors (2)     9.4.9 Glaucomas associated with elevated episcleral venous pressure (0)       9.4.10 Glaucomas associated with hemorrhage (0)     9.4.11 Glaucomas following intraocular surgery (0)       9.4.11.1 Ciliary block (malignant) glaucoma (0)       9.4.11.2 Glaucomas in aphakia and pseudophakia (3)       9.4.11.3 Epithelial, fibrous, and endothelial proliferation (0)       9.4.11.4 Glaucomas associated with corneal surgery (2)       9.4.11.5 Glaucomas associated with vitreoretinal surgery (2)     9.4.15 Glaucoma in relation to systemic disease (18)     9.4.20 Other (0) 10 Differential diagnosis e.g. anterior and posterior ischemic optic neuropathy (7) 11 Medical treatment (0)   11.1 General management, indication (3)   11.2 Cholinergic drugs (0)   11.3 Adrenergic drugs (0)     11.3.1 Epinephrine (0)     11.3.2 Thymoxamine, dapiprazole (0)     11.3.3 Apraclonidine, brimonidine (2)     11.3.4 Betablocker (8)     11.3.5 Other (0)   11.4 Prostaglandins (22)   11.5 Carbonic anhydrase inhibitors (1)     11.5.1 Systemic (0)     11.5.2 Topical (5)   11.6 Osmotic treatment (0)   11.7 Treatment of bloodflow (0)   11.8 Neuroprotection (31)   11.9 Gene therapy (2)   11.13 Combination therapy (0)     11.13.1 Betablocker and pilocarpine (0)     11.13.2 Betablocker and carbon anhydrase inhibitor (3)     11.13.3 Betablocker and brimonidine (0)     11.13.4 Betablocker and prostaglandin (6)     11.13.5 Other (0)   11.14 Investigational drugs; pharmacological experiments (17)   11.15 Other drugs in relation to glaucoma (10)   11.16 Vehicles, delivery systems, pharmacokinetics, formulation (11)   11.17 Cooperation with medical therapy e.g. persistency, compliance, adherence (4)   11.20 Other (0) 12 Surgical treatment (0)   12.1 General management, indication (0)   12.2 Laser iridotomy (6)   12.3 Laser iridoplasty (1)   12.4 Laser trabeculoplasty and other laser treatment of the angle (9)   12.7 Surgical iridectomy (2)   12.8 Filtering surgery (1)     12.8.1 Without tube implant (9)     12.8.2 With tube implant or other drainage devices (14)     12.8.3 Non-perforating (10)     12.8.4 Using laser (0)     12.8.5 Other (0)     12.8.10 Woundhealing antifibrosis (12)     12.8.11 Complications, endophthalmitis (6)   12.9 Trabeculotomy, goniotomy (3)   12.10 Cyclodestruction (2)   12.11 Cyclodialysis (0)   12.12 Cataract extraction (0)     12.12.1 Intracapsular (0)     12.12.2 Extracapsular (0)     12.12.3 Phacoemulsification (2)   12.14 Combined cataract extraction and glaucoma surgery (0)     12.14.1 Intracapsular (0)     12.14.2 Extracapsular (2)     12.14.3 Phacoemulsification (14)   12.15 Capsulotomy (0)   12.16 Vitrectomy (0)   12.17 Anesthesia (2)   12.20 Other (3) 13 Therapeutic prognosis and outcome (0)   13.1 Prognostic factors (0)   13.2 Outcome (0)     13.2.1 IOP (1)     13.2.2 Visual field (0)       13.2.2.1 Progression (1)       13.2.2.2 Improvement (0)     13.2.3 Other (0) 14 Costing studies; pharmacoeconomics (5) 15 Miscellaneous (25)

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Abstract #22984 Published in IGR 11-1

Corneal patch graft repair of exposed glaucoma drainage implants

Singh M; Chew PT; Tan D
Cornea 2008; 27: 1171-1173

See also comment(s) by Robert Feldman •

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PURPOSE: The purpose of this study was to describe a novel method of repair for exposed glaucoma drainage implants (GDIs) using corneal patch grafts. METHODS: This is a retrospective review of patients who underwent corneal patch graft repair of exposed GDIs at 2 tertiary ophthalmic centers in Singapore from November 1, 2000, to January 31, 2006. Surgical outcome was assessed in terms of tectonic integrity of the graft over the period of follow-up. Endpoints assessed were epithelialization of graft and absence of reexposure of GDI, scleral thinning, and infection. RESULTS: Eight eyes of 7 patients were analyzed, with a mean follow-up of 36.3 ± 28.4 months (range 11-83 months). The mean age of patients was 57.0 ± 20.8 years. The mean interval between GDI implantation and first occurrence of tube exposure was 22.1 ± 26.3 months (range 1-78 months). Six (75.0%) eyes had undergone 1 or more procedures for surgical repair of tube exposure before corneal patch graft surgery, including direct closure of conjunctival defect overlying the GDI tube or repair using conjunctival autograft or donor pericardium or sclera. After corneal patch graft surgery, 7 (87.5%) eyes had stable conjunctival coverage with no epithelial breakdown over the corneal patch graft and with no reexposure of the GDI, scleral thinning, or ocular infection during follow-up. CONCLUSIONS: Corneal patch graft repair of exposed GDIs is an effective method to provide stable GDI coverage after exposure.

Dr. M. Singh, Department of Ophthalmology, National University Hospital, Singapore, Sigapore

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Classification:

12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
9.4.11.4 Glaucomas associated with corneal surgery (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.11 Glaucomas following intraocular surgery)

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