Citation
Xue Yingying, Gao Ruxin, Zhang Jianhua, et al. Application of neurosurgical biological patches as cushion material during glaucoma drainage implant surgery in refractory glaucoma[J]. Chin J Exp Ophthalmol, 2026, 44(3):232-237. DOI: 10.3760/cma.j.cn115989-20250307-00073.
ABSTRACT [Download PDF] [Read Full Text]
Objective To investigate the clinical efficacy of using neurosurgical biological patch grafts as cushion materials during glaucoma drainage device (GDD) implantation in patients with refractory glaucoma.
Methods A prospective observational case series study was conducted. Ninety patients (97 eyes) who underwent GDD surgery with neurosurgical biological grafts as patch materials were enrolled at Xiamen Eye Center of Xiamen University from April 2020 to December 2023. The patients were followed up for 11-39 months, with an average of (20.3±4.2) months. The preoperative and postoperative visual acuity, intraocular pressure, number of anti-glaucoma medications used, complications, and reoperation rates were analyzed. This study adhered to the Declaration of Helsinki. The study protocol was approved by the Ethics Committee of Xiamen Eye Center of Xiamen University (No. XMYKZX-LW-2025-018). Written informed consent was obtained from each subject.
Results The visual acuity at the last follow-up was 0-0.6, showing a slight decrease compared with the preoperative 0-0.8. The intraocular pressure at the last follow-up was (15.4±6.4)mmHg (1 mmHg=0.133 kPa), and the number of anti-glaucoma drugs used was (0.83±0.65), which were significantly lower than (37.8±12.7)mmHg and (3.01±0.77) preoperatively, with statistical significance ( t=14.18, 18.74; both P<0.001). Postoperative shallow anterior chamber occurred in 9 eyes (accounting for 9.3%), hyphema in 3 eyes (accounting for 3.1%), drainage tube exposure in 4 eyes (accounting for 4.1%), and conjunctiva and patch tended to melt but healed spontaneously after conservative treatment (accounting for 1.0%). Among them, the exposure time of the drainage tube was about 1.50 to 12.00 months after surgery, with an average of (6.13±4.80) months, and no re-exposure occurred after repair. Postoperatively, 4 eyes (accounting for 4.1%) underwent cataract surgery, 2 eyes (accounting for 2.1%) underwent glaucoma surgery again due to increased intraocular pressure and poor drug control, and 4 eyes (accounting for 4.1%) underwent vitrectomy.
Conclusions Neurosurgical biological grafts used as patch materials in GDD surgery showes good safety in refractory glaucoma, and results in a low incidence of drainage tube exposure and other complications. It has demonstrated favorable long-term clinical outcomes.