Amniotic membrane transplantation for intraoperative conjunctival repair during trabeculectomy with mitomycin C

PURPOSE: To describe the use of amniotic membrane (AM) transplantation for the repair of conjunctival buttonholes during trabeculectomy with mitomycin C. METHODS: Four eyes of 3 patients with thin conjunctiva, precluding watertight conjunctival closure at the incision site with suturing, underwent intraoperative AM grafts over the leaking areas. RESULTS: In all eyes, a functional, nonleaking bleb was achieved. At the latest follow-up (8 to 30 mo), all eyes had intraocular pressures of 12 mm Hg or less without medications. CONCLUSIONS: AM transplantation was effective in the intraoperative closure of conjunctival buttonholes which developed at the incision line in 4 eyes. This intervention may be a useful addition to the glaucoma surgeon's repertoire of surgical techniques.