Pericardial Graft Thinning and Melting in Glaucoma Drainage Device Surgery

Risk Factors and Prevention Strategies

• Inadequate graft coverage of the tube, particularly at the limbus, is associated with increased risk of thinning, as reported by the American Academy of Ophthalmology 2, 3
• Suture-related irritation from braided materials like Mersilene polyester may contribute to tissue breakdown, according to the American Academy of Ophthalmology 2, 4, 3
• Elevated intraocular pressure and inflammation can accelerate tissue degradation, as noted by the American Academy of Ophthalmology 5, 1
• Poor wound closure technique leading to chronic low-grade inflammation is a risk factor for graft thinning, as reported by the American Academy of Ophthalmology 2, 3
• Ensuring adequate Tenon's membrane closure before conjunctival closure can help prevent graft thinning, as recommended by the American Academy of Ophthalmology 2, 3
• Selecting nylon over braided sutures can minimize chronic irritation and reduce the risk of graft thinning, according to the American Academy of Ophthalmology 2, 4, 3
• Rotating suture knots posteriorly beneath the graft can create a lower profile and reduce the risk of graft thinning, as reported by the American Academy of Ophthalmology 2, 4, 3