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Corneal graft patch to repair Baerveldt silicone tube and scleral buckling extrusions

Poster Details

First Author: E.Sarnicola ITALY

Co Author(s):    C. Sarnicola   G. Tosi   V. Sarnicola        

Abstract Details



Purpose:

To evaluate the efficacy of corneal and sclero-corneal graft used to cover Baerveldt valve silicone tube or scleral buckling extrusions.

Setting:

Misericordia Hospital, Grosseto, Italy.

Methods:

Retrospective, consecutive, non comparative cases series report about 12 patients with conjunctival erosion, related with Baerveldt valve silicone tube extrusion in 8 cases and scleral buckling extrusion in 4 cases. All cases of scleral buckling extrusion were treated with sclero-corneal graft patch. The movable conjunctiva was opened in flaps by Westcott scissors, as close as possible to the extrusion area. The conjunctival proliferation underlying the devices was removed. A sclero-corneal graft patch, denuded from corneal epithelium and endothelium, was then used to cover the scleral buckling extrusion. The graft patch was placed on the device with the endothelial side facing the sclera. Interrupted suture and fibrin glue were used between donor and recipient, and between the conjuctival flaps and the graft patch. The repair of the glaucoma valve's tube extrusion needed less graft tissue. The same surgical procedure was performed, but using just stromal corneal graft patch. The corneal graft patch, denuded from its epithelium, was reduced in its thickness to 400μ by using an artificial anterior chamber. Local steroids and antibiotics were used as postoperative treatment.

Results:

Corneal and sclero-corneal graft patches were vital at 1 month, 3 months and 6 months follow-up. The conjunctival flaps have progressively covered the whole grafted tissue at 3 months follow-up in 7 cases and at 6 months follow-up in 5 cases. No complications were recorded.

Conclusions:

Corneal and sclero-corneal graft patch seem to be a good option for the treatment of scleral buckling and Baerveldt valve silicon tube extrusions. However a larger number of cases and a longer follow-up are required to evaluate the actual success rate and possible late complications. FINANCIAL INTEREST: NONE

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