Long-term Safety and Efficacy of Conjunctival Pedicle Graft Revision Combined With Repeated Pericardium Allograft for Exposed Glaucoma Drainage Devices.

Abstract

To investigate the safety and long-term results of conjunctival pedicle graft (CPG) technique for revision of exposed glaucoma drainage device (GDD). Retrospective noncomparative case series. All patients with exposed GDD between 2011 and 2016 who underwent tube revision with CPG were included. Data from demographic variables, glaucoma subtype, previous surgeries, GDD type and location, patch graft nature, intraocular pressure, and intraoperative and long-term complications were collected. Eight eyes from 7 patients met the inclusion criteria. Median age was 61 years old (range, 51 to 80), median time to erosion was 23.4 months (range, 5 d to 45.1 mo), median number of operations before exposure was 3 (range, 1 to 5), and 6 tubes had an inferior location (75%). Average follow-up after repair was 24.3 months (range, 5.2 to 59.8 mo). No significant intraoperative adverse events were noted and visual acuity, intraocular pressure, and number of medications remained unchanged at 1 month after repair in all cases. We report 1 case of repeated tube exposure 24 months after CPG in a 51-year-old Afro-Caribbean woman with 5 previous operations. With an average follow-up of >2 years, we provide additional long-term evidence that CPG is a safe and effective technique for treating exposed tubes. We did not experience any complications and report 1 reexposure case in a young Afro-Caribbean patient with extensive previous conjunctival scarring.