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Surgical Technique
Surgeon's Corner
May 2013

Forniceal Conjunctival Pedicle Flap for the Treatment of Complex Glaucoma Drainage Device Tube Erosion

Author Affiliations

Author Affiliations: Glaucoma Associates of Texas (Drs Grover, Godfrey, and Fellman), and Oculoplastic Associates of Texas (Dr Merritt), Dallas.

JAMA Ophthalmol. 2013;131(5):662-666. doi:10.1001/jamaophthalmol.2013.2315

This retrospective study evaluated the safety and efficacy of the forniceal conjunctival pedicle flap for repair of conjunctival-deficient tube erosions. Additionally, we report the split-lid technique, a procedural improvement if fornix access is difficult. We identified 15 eyes of 14 consecutive patients with complex tube erosions. The mean age was 72.8 years and 33.3% had diabetes mellitus. Most patients were functionally monocular and 80% had undergone 4 or more prior ocular surgical procedures. There was no difference between the following preoperative and postoperative values: visual acuity, intraocular pressure, or number of glaucoma medications. The mean follow-up time after pedicle flap repair was 49 months. There were no recurrent erosions allowing for preservation of the drainage implant with excellent intraocular pressure control. This study demonstrates the relative long-term safety and success of this novel technique.