Dataset Information

Patch graft using collagen matrix (Ologen) for glaucoma drainage device exposure in a patient with Boston Keratoprosthesis type 1.

ABSTRACT: Purpose:To report the first successfully treated case of recurrent tube exposure in a patient with the Boston Keratoprosthesis type 1 with a collagen matrix patch graft (Ologen). Observations:A 50 year-old female with a Boston Keratoprosthesis type 1 and a history of Axenfeld-Reiger syndrome presents to our department with recurrent glaucoma drainage device exposure in her left eye. After failed spontaneous closure with topical antibiotics and lubricants, she undergoes tube exposure repair using an Ologen patch graft. Surgery was successful and the patient did not have any recurrence up to last follow-up two years post-operatively. Conclusion:Collagen matrix patch graft seems to be advantageous in treating glaucoma tube exposure in the Boston KPro eye, which is often a more challenging entity to treat. Importance:Collagen matrix patch graft could be considered as a primary patch graft in treating tube exposure in eyes with the Boston KPro.

SUBMITTER: Jabbour S

PROVIDER: S-EPMC6104558 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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Patch graft using collagen matrix (Ologen) for glaucoma drainage device exposure in a patient with Boston Keratoprosthesis type 1.

Jabbour Samir S Lesk Mark R MR Harissi-Dagher Mona M

American journal of ophthalmology case reports 20180818

<h4>Purpose</h4>To report the first successfully treated case of recurrent tube exposure in a patient with the Boston Keratoprosthesis type 1 with a collagen matrix patch graft (Ologen).<h4>Observations</h4>A 50 year-old female with a Boston Keratoprosthesis type 1 and a history of Axenfeld-Reiger syndrome presents to our department with recurrent glaucoma drainage device exposure in her left eye. After failed spontaneous closure with topical antibiotics and lubricants, she undergoes tube exposu ...[more]

PMID: 30140777

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Project description:ImportanceExposure of the tube of an aqueous drainage device (ADD) through the conjunctiva is a serious complication of ADD surgery. Although placement of gamma-irradiated sterile cornea (GISC) as a patch graft over the tube is commonly performed, exposures still occur.ObjectivesTo measure GISC patch graft thickness as a function of time after surgery, estimate the rate of graft thinning, and determine risk factors for graft thinning.Design, setting, and participantsCross-sectional study of graft thickness using anterior segment optic coherence tomography (AS-OCT) was conducted at the Wilmer Eye Institute at Johns Hopkins Hospital. A total of 107 patients (120 eyes, 120 ADDs) 18 years or older who underwent ADD surgery at Johns Hopkins with GISC patch graft between July 1, 2010, and October 31, 2016, were enrolled.InterventionImplantation of ADD with placement of GISC patch graft over the tube.Main outcomes and measuresGraft thickness vs time after ADD surgery and risk factors for undetectable graft.ResultsOf the 107 patients included in the analysis, the mean (SD) age of the cohort was 64 (16.2) years, 49 (45.8%) were male, and 43 (40.2%) were African American. The mean time of measurement after surgery was 1.7 years (range, 1 day to 6 years). Thinner grafts were observed as the time after surgery lengthened (??regression coefficient, -60 µm per year since surgery; 95% CI, -80 µm to -40 µm). The odds ratio of undetectable grafts per year after ADD surgery was 2.1 (95% CI, 1.5-3.0; P?<?.001). Age, sex, race, type of ADD, quadrant of ADD placement, diagnosis of uveitis or dry eye, and prior conjunctival surgery were not correlated with the presence or absence of the graft.Conclusions and relevanceGamma-irradiated sterile corneal patch grafts do not always retain their integrity after ADD surgery. Data from this cross-sectional study showed that on average, the longer the time after surgery, the thinner the graft. These findings suggest that placement of a GISC patch graft is no guarantee against tube exposure, and that better strategies are needed for preventing this complication.

Dataset Information

Patch graft using collagen matrix (Ologen) for glaucoma drainage device exposure in a patient with Boston Keratoprosthesis type 1.

Publications

Patch graft using collagen matrix (Ologen) for glaucoma drainage device exposure in a patient with Boston Keratoprosthesis type 1.

Similar Datasets

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