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Abstract #76346 Published in IGR 19-3
A Novel Hinged Scleral Patch Graft for the Repair of Overfiltration and Bleb Leaks
Mardelli PG; Mardelli PG; Mardelli ME; Mardelli ME; Bakkour ZJournal of Glaucoma 2018; 27: 377-381
INTRODUCTION: The repair of the scleral flap is often needed in cases of severe hypotony or bleb leaks with overfiltration. We present a simple novel technique to restore the hinged flap using a scleral patch graft. MATERIALS AND METHODS: We present 4 eyes of 4 patients who presented with hypotony [intraocular pressure(IOP) <6 mm Hg] from overfiltration secondary to loose scleral flap (2 eyes) and bleb leak (2 eyes). A scleral patch from a human donor, preserved in 95% ethanol, was cut in a trapezoidal shape and placed over the area of filtration after a conjunctival peritomy. The scleral graft was secured anteriorly with a single double-armed 9-0 nylon suture in a double-mattress manner so as to create a hinged flap. Permanent or releasable sutures were placed posteriorly to control aqueous outflow. RESULTS: All 4 patients had complete resolution of hypotony and bleb leaks with increase in their IOP to early teens. All maintained aqueous flow posteriorly with preservation of bleb function. CONCLUSION: Reestablishing the original anatomy of the hinged scleral flap can maintain bleb function without risk of overfiltration or loss of IOP control. This can be achieved through a simple repair using a scleral patch graft.
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Classification:
12.8.11 Complications, endophthalmitis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
12.20 Other (Part of: 12 Surgical treatment)
