Double-layer amniotic membrane may help repair exposed glaucoma tube shunts

A double layer of amniotic membrane can successfully manage erosion of the drainage tube following shunt surgery, according to a small case series.

Anthony King and colleagues at the Queens Medical Center in England described three female patients who had undergone drainage tube shunt surgery with the Ahmed valve for intractable glaucoma. The patients were 58-, 62- and 65-years-old. All three developed exposure of the tube secondary to necrosis of the overlying bovine pericardial patch and conjunctiva.

In these cases, the surgeons repaired the defects by using a double layer of amniotic membrane, with the inner layer acting as a graft and the outer layer as a patch. Autologous serum was used to promote epithelial growth, they said, and the patients were on the serum for 1 week following repair of the defect.

The authors believe this repair technique has not yet been described elsewhere. They said the technique offers “good long term results” for the treatment and closure of tube exposure in aqueous tube shunt surgery and can provide “an additional approach to the management of an often-difficult problem.”

The series is published in the British Journal of Ophthalmology.