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The use of a scleral micro-patch graft and fibrin glue to treat scleral flap defects following trabeculectomy
  1. A J King1,
  2. A P Rotchford2
  1. 1
    Department of Ophthalmology, University Hospital Nottingham NHS Trust, Nottingham, UK
  2. 2
    Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, UK
  1. Correspondence to Dr A J King, Department of Ophthalmology, Eye & Ear Building, University Hospital Nottingham NHS Trust, Nottingham NG7 2UH, UK; anthony.king{at}

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Gluing to restore corneal integrity following perforation and reform the anterior chamber (AC) is a well-established technique.1 2 Occasionally, similar anterior chamber problems such as hypotony or a flat or shallow AC occur following trabeculectomy, due to a defect, thinning or contraction of the scleral flap. The traditional approach has been to cover the flap defect with a large scleral or pericardial patch.3 4 This increases resistance over the leakage area and may overcome the hypotony. However, the results of such an intervention may be unpredictable.

Recently, fibrin glue has been described to secure the conjunctiva and scleral patch in glaucoma drainage device surgery.5 In this case report, a technique adapted from corneal gluing techniques is described2 which deals more directly with the area of the scleral flap defect.


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  • Competing interests None.

  • Provenance and Peer review Not commissioned; externally peer reviewed.

  • Patient consent Obtained.