A Hyperdry Amniotic Membrane Patch Using a Tissue Adhesive for Corneal Perforations and Bleb Leaks

PURPOSE: To evaluate the efficacy of hyperdry amniotic membrane (AM) patching attached using a tissue adhesive for corneal perforations and glaucoma filtering bleb leaks. DESIGN: Prospective, noncomparative, interventional case series. METHODS: Five eyes of 5 patients (glaucoma bleb leaks, 2 eyes; corneal perforations, 3 eyes) were treated with a single-layer patch of dried AM using a biological tissue adhesive. The dried AM was prepared with consecutive far,infrared rays and microwaves (hyperdry method) and was sterilized by gamma-ray irradiation. The dried AM was cut to the desired size and shape, and the tissue adhesive was applied to the amniotic epithelial side of the dried membrane. After applying the tissue adhesive, the dried membrane with glue applied then was positioned to cover the conjunctival bleb leak site or corneal perforation lesion using forceps. A therapeutic hydrogel contact lens then was installed as a bandage. RESULTS: Bleb leaks or corneal perforations were repaired successfully within 21 days in all 5 cases. There were no remarkable adverse effects, and there was no recurrence of bleb leak or corneal perforation. CONCLUSIONS: The hyperdry AM is a useful substrate, and this surgical procedure is a promising method to treat glaucoma filtering bleb leak or corneal perforation, which may result in serious vision-threatening ocular complications. (Am J Ophthalmol 2009;148: 383-389. (C) 2009 by Elsevier Inc. All rights reserved.)