Long-term outcomes of amniotic membrane transplantation for repair of leaking glaucoma filtering blebs

Purpose: To report long-term results of human preserved amniotic membrane transplant (AMT) vs conjunctival advancement for repair of late,onset glaucoma filtering bleb leakage. Design: Randomized, controlled trial (n = 30). Methods: Rates of bleb failure (reoperation for glaucoma or recurrent bleb leak) were compared. Results: Median follow,up was 80 months. Final intraocular pressure (IOP) was 10.9 +/- 0.9 mm Hg with AMT and 12.7 +/- 1.3 mm Hg with conjunctival advancement (P = .28). The number of glaucoma medications and final visual acuities were similar between groups. Bleb vascularity was significantly less with AMT (P = .02). Seven failures occurred with AMT, four requiring reoperation for bleb leakage and three requiring reopera- tion for glaucoma. Four failures occurred with conjunc- tival advancement, one requiring reoperation for leakage and three requiring reoperation for glaucoma. Kaplan, Meier survival curves were statistically similar between groups, with a trend favoring conjunctival advancement (P = .44). Conclusions: Although prone to early releakage, AMT may be a suitable alternative to conjunctival advancement in the long-term.