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 reoperation for glaucoma. Four failures occurred with conjunctival 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.