PURPOSE:In this study, we described the experience of using autologous
fibrinogen comcentrate (AFC)to treat patients with persistent hypotony after
glaucoma filtration surgery. METHODS: Among seven MMC augmented trabeculectomy
patientsd who developed persistent post-operative hypotony, the effects of AFC subconjunctival
injection were evaluated. The AFC was prepared by our blood bank. Under
microscope,0.2 mL AFC and bovine thrombin (Thrombosat, Parke-Davis, Sydney,
Australia) were injected to the blebs of these patients from both sides of
conjunctiva. Postoperatively, best-corrected visual acuity, anterior chamber,
intraocular pressure (IOP) and fundus examinations were followed and compared
with those pre-operatively. RESULTS: On the second day after subconjunctival
injection of AFC, the mean IOP elevated from 3.4 2.1 mmHg to 12.6
4.2 mmHg, and the anterior chamber became deep without obvious
inflammation response. Within 2 weeks, macular edema and visual acuity were
noted to improve in 6 cases (85.7%). In addition, after a mean follow-up for 25
months, the trabeculectomy procedure remained sucessful in all cases.
CONCLUSIONS: AFC appeared to be safe and effective in the treatment of ocular
hypotony after glaucoma filtration surgery, while the outcome of filtration
surgery was not influenced.