Autologous Partial-thickness Scleral Flap and Donor Corneal Graft in Management of Tube Erosion of Glaucoma Drainage Device.

Abstract

To evaluate the outcomes of autologous limbus-hinged partial-thickness scleral flap and half-moon-shaped split-thickness donor corneal allograft in management of tube erosion of glaucoma drainage device. Consecutive patients who had undergone a limbus-hinged partial-thickness scleral flap and half-moon-shaped split-thickness corneal graft were reviewed. Primary outcome was surgical success of coverage of the exposed tube without complications or additional surgeries. Secondary outcomes were visual acuity (VA), intraocular pressure, number of glaucoma medications, surgical complications, and additional surgeries. From March 1, 2016 to August 30, 2017 (18 mo), 8 consecutive cases (7 patients) of tube erosions were included for analysis. Mean follow-up and age were 16.6±5.4 months and 74.4±15.2 years, respectively. Mean number of intraocular surgeries was 4.8±1.6 (range: 3 to 6 surgeries) and intraocular glaucoma surgeries was 2.9±1.7 (range: 1 to 6 surgeries) before tube erosion. There were no intraoperative or postoperative complications or recurrence of tube erosion in any patient. Differences between the preoperative and postoperative number of medications (2.6±1.8, 2.9±1.8, respectively; P=0.171) and intraocular pressure (12.9±6.9, 10.8±3.5 mm Hg, respectively; P=0.209) were not statistically significant. Preoperative and 3-month postoperative VA were identical in all eyes except in 1 eye that the VA improved from 20/300 to 20/70 after repair. Combination of limbus-hinged partial-thickness scleral flap and half-moon-shaped split-thickness corneal allograft is a viable surgical option to repair tube erosion.