Pericardium Patch Graft (Tutoplast) for Bleb Repair and Bleb Remodelling After Nonpenetrating Filtering Surgery: 6-Month Outcomes

Abstract

Purpose: The purpose of this study was to evaluate the outcome of pericardium patch graft (Tutoplast) as an adjuvant to either bleb repair or bleb reduction after nonpenetrating filtering surgery. Methods: Retrospective study, at a tertiary glaucoma center. Bleb revision with Tutoplast positioning was performed either for bleb repair to treat early leaks or hypotony with maculopathy, either for bleb reduction to improve ocular pain, discomfort, burning, foreign body sensation, tearing, and fluctuations of visual acuity. Intraocular pressure (IOP), best corrected visual acuity, number of antiglaucoma medications, and postoperative complications were analyzed postoperatively at 1 week, 1, 3, 6 months, and compared with the preoperative baseline. Surgical success was defined as achieving an IOP between 8 and 16 mm Hg. Results: Six-month data were available from 15 eyes of 15 patients; mean patient age was 69.6±11.7 (66.7% male). Bleb revision was necessary for 10 patients due to bleb dysesthesia (bleb reduction), and in 5 patients due to leaking filtering bleb (bleb repair). The success rate was 73.3% at 6 months, with a significant IOP increase from 4.9±2.2 mm Hg preoperatively to 12.7±3.5 mm Hg at 6 months (P=0.0001), and a concomitant rise of best corrected visual acuity from 0.5±0.3 to 0.6±0.3 (P=0.2871). To control IOP, antiglaucoma medications were needed for 3 patients (20%) at 6 months. Overall, 3 patients (20%) required additional bleb revision for persistent hypotony, and 1 patient underwent a subsequent glaucoma surgery (transscleral cyclodestruction). Conclusion: Pericardium patch graft (Tutoplast) is a safe and effective adjuvant for bleb revision due to bleb dysesthesia of leaking filtering bleb after nonpenetrating filtering surgery.

Human pericardial extracellular matrix: An implantation platform for cardiac tissue engineering

“…In brief, pericardium grafts have been applied to correct intracardiac and diaphragm defects (Ricci et al, 2014;Yaliniz et al, 2014;Ascaso et al, 2021), as well as ischemic ventricular septal defect after acute MI (Mihalj et al, 2022). On the other hand, non-cardiac pericardium-based applications include replacement of brain dura mater (Sun et al, 2018), bleb repair, conjunctival reconstruction, cover of severe corneal wound or tendon elongation in the eye (Niegowski et al, 2020;Ashena et al, 2021;Hedergott et al, 2021;Chen et al, 2022), odontology (Solakoğlu et al, 2022) and eardrum reconstruction (de Dorldodot et al, 2013;Sainsbury et al, 2022). Furthermore it has been employed to generate a variety of bioprostheses such as vascular grafts, patches for abdominal or vaginal wall reconstruction and heart valves (Rémi et al, 2010).…”

Allogenic dehydrated human pericardium patch graft (Tutoplast): A novel use for reconstruction in orbital implant exposure

“…6 It has previously been used as a patch graft for scleral thinning following squint surgery, 7 exposed scleral buckles 8 and drainage device exposure following glaucoma surgery. 9,10 In this paper, we report the novel use of Tutoplast ® pericardium patch graft in treating implant exposure.…”