Long-term results of amniotic membrane transplantation-assisted bleb revision for leaking blebs.

Background: To report long-term results of amniotic membrane transplantation (AMT)-assisted bleb revision for intractable late-onset bleb leak.
Methods: Retrospective medical record review of six consecutive patients who underwent AMT-assisted bleb revision for late-onset bleb leak at the Kobe University hospital between December 2001 and March 2004.
Results: The median (range) of age was 60 (20-77) years. All patients had a history of trabeculectomy with adjunctive use of 0.4 mg/ml mitomycin C. The median (range) of interval between the prior trabeculectomy and bleb leak was 15 (4-54) months. Preoperative intraocular pressure (IOP) was lower than 10 mmHg in two cases, while it was 25 mmHg or higher in three patients, who had a localized, ischemic, thin-wall leaking bleb circumscribed with extensively scarred tissue. The median (range) of follow-up after the AMT-assisted bleb revision was 49 (41-67) months. Postoperative IOP was well controlled in all patients without medication or with a maximum of three glaucoma medications. No patients presented recurrence of the bleb leak or AMT-related complications during entire follow-up. All patients showed at final visit a diffuse bleb which extended posteriorly beyond the conjunctival incision line.
Conclusion: AMT-assisted bleb revision successfully treated intractable late-onset bleb leak. Further comparative studies are needed to confirm the present result.