Revision of leaking bleb with sterile cord wall amniotic membrane graft

To report the use of a devitalized, dehydrated human cord wall amniotic membrane to repair a late bleb leak with a scleral defect occurring long after a trabeculectomy. A 32-year-old woman presented with a bleb leak and underlying scleral thinning at the site of a trabeculectomy performed 10 years previously, inducing severe ocular hypotony. The bleb leak was persistent after multiple surgeries, including a conjunctival flap and lyophilized amniotic membrane grafting. A lyophilized cord wall amniotic membrane graft (SclerFIX®, TBF Genie Tissulaire, Mions, France) was used to repair the bleb. At 6 months postoperatively, the graft was intact, the bleb was formed, and no leakage was noted. The intraocular pressure was 12 mmHg. Cord wall amniotic membrane grafting appears to be useful for revision of a leaking bleb. It is simple and quickly accessible, requiring no additional surgery. Further studies with larger sample sizes would be ideal to confirm this result.