Combined use of a novel dried cross-linked amniotic membrane and tissue adhesive to conjunctival defect following multiple trabeculectomy

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Abstract

A 74-year-old woman underwent trabeculectomy with mitomycin C in the left eye. A large conjunctival defect with aqueous leakage suddenly developed 2 days postoperatively. The patient had undergone extracapsular cataract extraction and five previous trabeculectomy procedures in the left eye. Amniotic membrane dried by a new method (Hyper-dry), then cross-linked by glutaraldehyde was inserted underneath the conjunctival bleb through the conjunctival defect site and 2-octyl cyanoacrylate adhesive was applied to the surrounding area inside the conjunctival defect edge to secure the amniotic membrane to the conjunctiva. The bare surface of the transplanted amniotic membrane was gradually covered with conjunctival epithelia and the defect was completely sealed14days later. The dried, cross-linked amniotic membrane did not dissolve during the 24-month follow-up period. This procedure may become a superior method of treating conjunctival defect following trabeculectomy and the novel dried cross-linked amniotic membrane appears to be a useful therapeutic material for glaucoma surgery.

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