Subconjunctival placement of human amniotic membrane during high risk glaucoma filtration surgery

Abstract

Background and objective: To determine whether subconjunctival placement of amniotic membrane improves filtration results in patients with glaucoma at high risk for surgical failure.

Patients and methods: Retrospective review of 17 eyes of 15 patients who had amniotic membrane applied during glaucoma surgery with or without mitomycin C or 5-fluorouracil.

Results: Mean intraocular pressure decreased from 27.0 +/- 9.1 mm Hg preoperatively to 18.1 +/- 11.0 mm Hg postoperatively with a mean follow-up of 179 days. Complications included self-limited conjunctival wound dehiscence (n = 5), uveitis recurrence (n = 2), and cataract progression (n = 1).

Conclusions: The results suggest that subconjunctival placement of amniotic membrane may improve filtration outcome in high risk eyes. It will be of interest to determine whether the anti-inflammatory, anti-angiogenic, and antifibrotic properties of amniotic membrane placed subconjunctivally and under the scleral flap will improve filtration surgery outcome by a prospective, randomized study.