Buccal mucous membrane for the reconstruction of complicated leaking trabeculectomy blebs

Dan B. Rootman, Nikhil L. Kumar, David S. Rootman, Graham E. Trope

    Research output: Contribution to journalArticle

    16 Citations (Scopus)

    Abstract

    Purpose: Late onset trabeculectomy bleb leaks often require surgical repair to avoid hypotony and/or infection. Repair using local conjunctiva is typically performed. However, in cases in which local conjunctiva is limited and/or has failed, buccal mucous membrane can be used as a conjunctival substitute. Methods: Four cases of buccal mucous membrane repair for leaking trabeculectomy blebs are reported. Surgical technique is described. Results: In each case of bleb leak, multiple nonincisional techniques failed to control the leak. In 3 of 4 cases, earlier reconstruction attempts with conjunctival advancement and/or free flaps failed. Each was ultimately repaired with buccal membrane autograft. One case required additional minimally invasive procedures to control postoperative leaking. One case required a second adjacent buccal graft for leaking residual conjunctival bleb. Each graft was functioning well at most recent follow-up ranging from 1 to 17 months. Discussion: Buccal membrane is an abundant and effective conjunctival substitute for the repair of recalcitrant leaking trabeculectomy blebs. It may be useful in cases in which earlier conjunctival-based repairs have failed.

    Original languageEnglish
    Pages (from-to)270-274
    Number of pages5
    JournalJournal of Glaucoma
    Volume19
    Issue number4
    DOIs
    Publication statusPublished - Apr 2010

    Keywords

    • Bleb leak
    • Buccal membrane
    • Surgical technique
    • Trabeculectomy complications

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