Tube shunt coverage with gamma-irradiated cornea allograft (VisionGraft)

Abstract

PurposeTo investigate the clinical outcomes of tube shunt coverage using sterile gamma-irradiated cornea allograft.Patients and methodsThe Wills Eye Hospital Glaucoma Research Center retrospectively reviewed the medical records of 165 patients who underwent glaucoma tube shunt procedures using sterile gamma-irradiated cornea allograft (VisionGraft) between December 2012 and November 2013. Demographic characteristics, type of tube shunt, and position were noted. Complications were recorded at 1 day; 1 week; 1, 3, 6, and 12 months; and on the final postoperative visit.ResultsOne hundred and sixty-nine eyes of 165 patients were included. The mean follow-up time was 4.8±3.5 (ranging from 1 to 16) months. There was no evidence of immunological reaction, infection, or exposure in 166 eyes (98.2%). Three eyes (1.8%) experienced graft or tube exposure within the first 3 postoperative months. Two of the cases had underlying diseases: bullous pemphigoid and chronic allergic conjunctivitis.ConclusionCoverage of tube shunts using gamma-irradiated cornea allograft had a low exposure rate and was well tolerated. The graft can be stored long term at room temperature and has an excellent postoperative cosmetic appearance.

Clinical outcomes of gamma-irradiated sterile cornea in aqueous drainage device surgery: a multicenter retrospective study

“…31 As is known, GISC has the advantages of transparence and a long-stable shelf life. 16 Therefore, the rationale for the use of GISC in ADD surgeries is likely that GISC remedies the defects of optisol-stored fresh cornea and glycerol-stored cornea with its unique features.…”

“…GISC has been successfully demonstrated to have good biocompatibility when used for glaucoma patch graft, corneal lamellar keratoplasty, and as a biological skirt for keratoprosthesis. [13][14][15] The use of GISC as coverage patch in primary or secondary ADD surgery with short follow-up of 4.8 ± 3.5 months has been recently reported; 16 however, GISC is a relatively new material and the long-term clinical results in coverage of ADD are limited. To better evaluate the safety and effectiveness of the GISC as patch graft in ADD surgery, we performed a multicenter retrospective study, paying special attention to the function of GISC as tube coverage to prevent erosion and other GISC-related complications over a mean follow-up of 15.4 months.…”

Corneal Patch Graft

“…21,22 The clarity of graft compared with the sclera provided a good cosmetic result in these patients. 23 The lesser chance of sloughing and graft dehiscence may be explained with more firmly packed lamellar structure of cornea and good reepithelialization of this tissue and the better donor-host adhesion. 23,24 However, the patients may be unsatisfied with visualization of dark choroid immediately after corneal patch graft.…”

“…23 The lesser chance of sloughing and graft dehiscence may be explained with more firmly packed lamellar structure of cornea and good reepithelialization of this tissue and the better donor-host adhesion. 23,24 However, the patients may be unsatisfied with visualization of dark choroid immediately after corneal patch graft. This cosmetic issue can be resolved by covering the graft with the conjunctiva.…”

The structure and evolution of eye banking: a review on eye banks’ historical, present, and future contribution to corneal transplantation

“…102 Previous studies have used donor dura, sclera, pericardium, fascia lata, porcine intestinal mucosa, and amniotic membrane as patch grafts for these tube erosions. 101,103 Corneal patch grafts have also been used for leaky scleral flaps following trabeculectomy. 104 Corneas are preferred over other tissue for their remarkable tensile strength, transparency, and ease of surgical use.…”