Corneal patch graft repair of exposed glaucoma drainage implants

Purpose: The purpose of this study was to describe a novel method of repair for exposed glaucoma drainage implants (GDIs) using corneal patch grafts. Methods: This is a retrospective review of patients who underwent corneal patch graft repair of exposed GDIs at 2 tertiary ophthalmic centers in Singapore from November 1, 2000, to January 31, 2006. Surgical outcome was assessed in terms of tectonic integrity of the graft over the period of follow-up. Endpoints assessed were epithelialization of graft and absence of reexposure of GDI, scleral thinning, and infection. Results: Eight eyes of 7 patients were analyzed, with a mean follow-up of 36.3 ± 28.4 months (range 11-83 months). The mean age of patients was 57.0 ± 20.8 years. The mean interval between GDI implantation and first occurrence of tube exposure was 22.1 ± 26.3 months (range 1-78 months). Six (75.0%) eyes had undergone 1 or more procedures for surgical repair of tube exposure before corneal patch graft surgery, including direct closure of conjunctival defect overlying the GDI tube or repair using conjunctival autograft or donor pericardium or sclera. After corneal patch graft surgery, 7 (87.5%) eyes had stable conjunctival coverage with no epithelial breakdown over the corneal patch graft and with no reexposure of the GDI, scleral thinning, or ocular infection during follow-up. Conclusions: Corneal patch graft repair of exposed GDIs is an effective method to provide stable GDI coverage after exposure.