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Beitragstitel Pericardium Patch Graft (Tutoplast®) for Bleb Repair and Bleb Remodelling after Nonpenetrating Filtering Surgery: Six-Month Outcomes.
Autor:innen
  1. Laëtitia Jessy Niegowski Clinique de l'Oeil, Onex Präsentierende:r
  2. Giorgio Enrico Bravetti University Hospitals Geneva and University of Geneva
  3. Kevin Gillmann Clinique Montchoisi Lausanne
  4. Kaweh Mansouri Swiss Visio Montchoisi, Lausanne, Switzerland
  5. André Mermoud Glaucoma Research Center, Montchoisi Clinic, Swiss Visio, Lausanne, Switzerland
Präsentationsform ePoster
Themengebiete
  • Glaucoma
Abstract-Text PURPOSE:
To evaluate the outcome of pericardium patch graft (Tutoplast®) as an adjuvant to bleb revision procedures following nonpenetrating filtering surgery.

METHOD:
This is a retrospective study carried out at a tertiary glaucoma centre. In patients who presented post-operative hypotony and/or hypotony maculopathy, bleb revision with Tutoplast® was performed either for bleb repair to treat early leaks, or for bleb remodelling and reduction to reduce an excessive filtration and improve visual discomfort. Intraocular pressure (IOP), best corrected visual acuity (BCVA), number of antiglaucoma medications and post-operative complications were analysed post-operatively at 1 week, 1 month, 3 months, 6 months and compared to the pre-operative baseline. Surgical success was defined as persistent resolution of the surgical indication (hypotony maculopathy, bleb leak or excessive bleb filtration) while achieving an IOP between 8 and 16 mmHg, without subsequent glaucoma surgery.

RESULTS:
Six-month data were available from 15 eyes of 15 patients. The mean patient age was 69.6 ± 11.7 years (66.7% male). Bleb revision was necessary in 10 patients due to excessive bleb filtration (bleb remodelling and reduction) and in 5 patients due to leaking filtering bleb (bleb repair). The success rate was 73.3% at 6 months with a significant IOP increase from 4.9 mmHg ± 2.2 pre-operatively to 12.7 mmHg ± 3.5 at 6-month (P < 0.0001) and a concomitant rise of BCVA from 0.5 ± 0.3 to 0.6 ± 0.3 (P = 0.2871). Overall, 3 eyes (20%) required additional bleb revision for persistent hypotony, and 4 eyes (27%) experienced hypertony. Out of the latter, 3 (20%) required antiglaucoma medications to achieve target IOPs and 1 underwent a subsequent glaucoma surgery (transcleral cyclodestruction).

CONCLUSION:
Pericardium patch graft (Tutoplast®) is a safe and effective adjuvant for bleb revision in leaking blebs and excessive bleb filtration following nonpenetrating filtering surgery. Nevertheless, ophthalmologists should be aware of the relatively high rate of required post-operative revisions.