A novel use of amniotic membrane in the management of tube exposure following glaucoma tube shunt surgery

Aim: To report a novel technique using amniotic membrane to cover exposed glaucoma tube shunts. Methods: A consecutive series of three cases that underwent drainage tube shunt surgery with the Ahmed valve for intractable glaucoma. All three patients developed exposure of the tube secondary to necrosis of the overlying bovine pericardial patch and conjunctiva. Repair of the defect was carried out with a double layer of amniotic membrane, the inner one acting as a graft and the outer as a patch. Autologous serum was used to promote epithelial growth. Results: Successful lasting closure of the conjunctival defect was achieved in all cases. Conclusion: Erosion of the drainage tube following shunt surgery is a potentially serious problem. It can be successfully managed using a double layer of amniotic membrane.