Electron Beam Irradiated Corneal Versus Gamma-Irradiated Scleral Patch Graft Erosion Rates in Glaucoma Drainage Device Surgery

Passo, Ross; Hoskins, Zachary B.; Tran, Khoa D.; Patzer, Corrina; Edmunds, Beth; Morrison, John C.; Parikh, Mansi; Takusagawa, Hana L.; Tehrani, Shandiz

doi:10.1007/s40123-019-0190-x

Cited by 8 publications

(6 citation statements)

References 20 publications

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“…The reported rate of tube exposure ranges from 1.8% to 8.9%. [ 1 - 6 , 18 - 21 ] The overall conjunctival complication rate of 7.1% in our study is comparable with that reported in the literature. It is slightly less than that reported in the tube versus trabeculectomy study (5%).…”

Section: Discussionsupporting

confidence: 89%

Comparison of conjunctiva-related complications between scleral and corneal patch grafts in Ahmed glaucoma valve implantation

Panda

Khurana

Vijaya

et al. 2023

Indian Journal of Ophthalmology

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Purpose: Comparison of the conjunctiva related complication rates and success rates among eyes with Ahmed glaucoma valve (AGV) implantation in which eye bank derived scleral and corneal patch grafts had been used to cover the tube. Methods: Retrospective comparative study. Patients who underwent AGV implantation between January 2000 to December 2016 were included. Demographic, clinical data, intra and post operative data was obtained from electronic medical records. Conjunctiva related complications were divided into two groups: with and without implant exposure. Conjunctiva related complication rates, success rate, risk factors among eyes with corneal and scleral patch graft were compared. Results: Three hundred and twenty three eyes of 316 patients underwent AGV implantation. Scleral patch graft was used in 214 eyes of 210 patients (65.9%) and corneal patch graft was used in 109 eyes of 107 patients (34%). Median follow up was 14 months. There was no significant difference in the conjunctiva related complication rate (7.3 % in corneal patch graft versus 7.0% in scleral patch graft;p=0.5) and conjunctival dehiscence rate (3.7% versus 4.6%, P = 0.7) among the two groups. Success rate was significantly higher in the corneal patch graft group versus the scleral patch graft group (98% versus 72%; p=0.001). Eyes with corneal patch graft had a higher survival rate ( P = 0.01). Conclusion: There was no significant difference in the rate of conjunctiva related complications following corneal and scleral patch grafts used to cover the AGV tube. Eyes with corneal patch graft had a higher success rate and survival rate.

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Section: Discussionsupporting

confidence: 89%

Comparison of conjunctiva-related complications between scleral and corneal patch grafts in Ahmed glaucoma valve implantation

Panda

Khurana

Vijaya

et al. 2023

Indian Journal of Ophthalmology

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“…However, we can infer and compare the effects based on studies in patients who underwent glaucoma valve surgery with corneal grafting. These studies showed comparable tectonic results between corneal and scleral grafts, and they found that surgeons used corneal grafts 3.8 times more frequently than scleral grafts [20,21] . In addition, evidence suggests that acellular preserved corneal grafting is effective for reducing inflammation and promoting wound healing in rabbits [10] …”

Section: Discussionmentioning

confidence: 92%

“…[10] This study was limited by the small number of patients and short follow-up duration. Nevertheless, it provides evidence that acellular preserved corneal grafting promotes wound healing, has comparable tectonic success rates to those of traditionally used Oh JH [20] 8 Scleromalacia AMT 1 24 100 0 Fresh Donor Cornea Naseripour M [12] 4 Necrotizing scleritis None NA 28.5 100 0 Ti SE [14] 20 Infectious scleritis Conjunctival flap NA 14 95 5 ‡ Kymionis GD [15] 1 Necrotizing scleritis None 2 12 100 0 Lin HC [16] 1 Infectious scleritis Conjunctival flap NA 24 100 0 Ramos-Esteban [17] 1 Infectious scleritis Pericardium NA 16 100 0 Acellular preserved cornea…”

Section: Discussionmentioning

confidence: 98%

“…These studies showed comparable tectonic results between corneal and scleral grafts, and they found that surgeons used corneal grafts 3.8 times more frequently than scleral grafts. [20,21] In addition, evidence suggests that acellular preserved corneal grafting is effective for reducing inflammation and promoting wound healing in rabbits. [10] This study was limited by the small number of patients and short follow-up duration.…”

Section: Discussionmentioning

confidence: 99%

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Preserved corneal lamellar transplantation for infectious and noninfectious scleral defects

2021

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Rationale : Reinforcement of thinned or necrotizing sclera has been conducted using various materials, including allogeneic sclera, allogenic cornea, amniotic membrane, fascia lata, pericardium, periosteum, and perichondrium. Among them, good outcomes have traditionally been obtained using preserved scleral grafts. However, scleral patch grafts have complications such as graft retraction, thinning, dehiscence, and necrosis. Furthermore, to promote epithelial healing, scleral patch grafting must be accompanied by procedures such as amniotic membrane transplantation (AMT) or grafting using conjunctival flaps or autografts. Recently, acellular preserved human corneas have been used in various ophthalmic surgeries, with emerging evidence supporting its use for treating scleral defects as an option that does not require AMT or conjunctival autografting. We investigated whether corneal patch grafting would show wound healing and tectonic success rate outcomes comparable to those of existing techniques.Patient presentation : Three patients presented with intractable ocular pain. Slit-lamp examination showed marked scleral thinning at the nasal side.Diagnosis : Scleral thinning progressed with conservative treatment; microbial staining and culturing were performed. Infectious or non-infectious scleritis was diagnosed according to slit-lamp examination and microbial culture results.Interventions : A preserved corneal lamellar patch was grafted at the scleral thinning area.Outcomes All patients achieved tectonic success with reduction of inflammation following corneal patch grafting. Two patients achieved complete re-epithelialization within 7 days, while 25 days were required for the third patient. No patients experienced graft thinning, rejection, or infection.Lessons : Our report suggests the feasibility of using acellular preserved human cornea patch grafts to reinforce inflammatory scleral defects and obtain successful outcomes in terms of wound healing. This technique shows a comparable tectonic success rate and superior effect on scleral defect healing without the need for adjunctive AMT or conjunctival autografting.

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“…Although there was no erosion event in either group, the corneal graft was greatly to be preferred. 23 Despite these interests, to the best of our knowledge, there has been no interventional study designed to investigate the comparative effects of tectonic lamellar corneal grafting and scleral grafting on wound healing and inflammation.…”

Section: Discussionmentioning

confidence: 99%

Preserved Corneal Lamellar Grafting Reduces Inflammation and Promotes Wound Healing in a Scleral Defect Rabbit Model

Kim

Ryu

Kim

et al. 2020

Trans. Vis. Sci. Tech.

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Purpose To investigate the effect of preserved corneal lamellar grafting on inflammation and wound healing and to compare its effect with that of preserved scleral grafting in a scleral defect rabbit model. Methods New Zealand White rabbits were assigned to a corneal lamellar grafting group ( n = 5) or a scleral grafting group ( n = 5). After lamellar dissection of superotemporal sclera using 6.0-mm trephine, the same sizes of preserved human corneal or scleral grafts were transplanted with 10-0 nylon interrupted sutures. The grafted areas were photodocumented at 3 to 21 days after surgery to evaluate epithelial wound healing index (%), neovascularization and presence of filaments. The existence of CD3 + T cells and CD34 + cells at the grafted areas was analyzed at 21 days. Results Epithelial wound healing index was significantly higher in the corneal grafting group at 9 days ( P < 0.05). Scleral grafts showed copious formation of filaments adherent to the engrafted area from 9 to 14 days, whereas the corneal grafts were free of filaments. The numbers of inflammatory cells were significantly higher in the scleral grafts ( P < 0.05), and CD3 + T cells and CD34 + cells were populated within inflammatory cells at graft–recipient junctions in both groups. The mean areas of the estimated perigraft and intragraft neovascularization tended to be higher in scleral grafts. Conclusions Preserved corneal lamellar grafting enhances epithelial wound healing and alleviates inflammation in a scleral defect rabbit model. Translational Relevance This work suggests that the preserved corneal graft may be considered as a favorable alternative option for repairing scleral defects.

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Electron Beam Irradiated Corneal Versus Gamma-Irradiated Scleral Patch Graft Erosion Rates in Glaucoma Drainage Device Surgery

Cited by 8 publications

References 20 publications

Comparison of conjunctiva-related complications between scleral and corneal patch grafts in Ahmed glaucoma valve implantation

Comparison of conjunctiva-related complications between scleral and corneal patch grafts in Ahmed glaucoma valve implantation

Preserved corneal lamellar transplantation for infectious and noninfectious scleral defects

Preserved Corneal Lamellar Grafting Reduces Inflammation and Promotes Wound Healing in a Scleral Defect Rabbit Model

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