[Repair of a leaking bleb filtration with conjunctival and amniotic membrane transplantation]. / Comunicación corta. Reparación de ampolla filtrante postrabeculectomía con injerto de conjuntiva y membrana amniótica.

CLINICAL CASE: A 71-year-old woman presented with a leaking bleb after a combined phacotrabeculectomy performed 13 years ago. To construct a new filtering bleb, the necrotic area was fully excised. The amniotic membrane was inserted over the scleral flap underneath healthy conjunctiva edges. A conjunctiva-Tenon autograft from the contralateral eye was sutured and was sealed with fibrin adhesive. DISCUSSION: We propose a new surgical technique to repair late leak failures after trabeculectomy with mitomycin C in blebs with a large avascular area. Transplantation of amniotic membrane and conjunctival autograft may be used to repair late leak failures with inadequate conjunctiva to advance.

Comunicación corta. Reparación de ampolla filtrante postrabeculectomía con injerto de conjuntiva y membrana amniótica / Repair of a leaking bleb filtration with conjunctival and amniotic membrane transplantation

Caso clínico: Mujer de 71 años que presenta punto de fuga en la ampolla de una facotrabeculectomíarealizada 13 años antes. Se reseca área necrótica y se sutura trasplante demembrana amniótica sobre el tapete escleral hiperfiltrante. Sobre esta se sutura injerto deconjuntiva y Tenon del ojo contralateral.Discusión: Se propone nueva técnica quirúrgica para el tratamiento de fístula de filtracióntardía tras trabeculectomía con mitomicina C y área avascular extensa. Se aplica adhesivo defibrina para el sellado de incisiones. El doble trasplante de membrana amniótica y conjuntivacontralateral puede utilizarse para reparar puntos de fuga tardíos postrabeculectomía conconjuntiva insuficiente(AU)

Clinical Case: A 71-year-old woman presented with a leaking bleb after a combined phacotrabeculectomyperformed 13 years ago. To construct a new filtering bleb, the necrotic areawas fully excised. The amniotic membrane was inserted over the scleral flap underneathhealthy conjunctiva edges. A conjunctiva-Tenon autograft from the contralateral eye wassutured and was sealed with fibrin adhesive.Discussion: We propose a new surgical technique to repair late leak failures after trabeculectomywith mitomycin C in blebs with a large avascular area. Transplantation of amniotic membrane and conjunctival autograft may be used to repair late leak failureswith inadequate conjunctiva to advance(AU)

Role of renal prostaglandin E2 in chronic renal disease hypertension.

The role played by renal prostaglandin E2 in the maintenance of hypertension in chronic renal disease has been investigated through studying the response of body weight, blood pressure, glomerular filtration rate (GFR), 24-hour natriuresis, plasma renin activity (PRA), plasma aldosterone and urinary PGE2 excretion to the administration of indomethacin (2mg/kg daily, during 3 days). A group of 37 patients diagnosed as having chronic renal parenchymatous disease with creatinine clearance above 25 ml/min was included in the study. 21 of them were hypertensive (BP greater than 160/95). 27 normotensive volunteers were also studied and considered as the control group. The initial study disclosed similar levels of PGE2, PRA and plasma aldosterone in volunteers, normotensive patients and hypertensive patients, although the sodium intake was lower in the last two groups. A positive correlation between PRA and urinary PGE2 was found both in normotensive (r = 0.507, p less than 0.01) and in hypertensive patients (r = 0.609, p less than 0.01). The administration of indomethacin induced a diminution of PRA, plasma aldosterone and urinary PGE2 levels together with an increase in diastolic blood pressure (p less than 0.05-0.01) in both volunteers and patients. The remaining parameters measured did not change in volunteers or in normotensive patients. On the contrary, in hypertensive patients, during indomethacin administration, lower values of creatinine clearance (p less than 0.005) and 24-hour natriuresis (p less than 0.05) together with an increase in body weight (p less than 0.01) were observed. These results point to the existence of a protective role of renal prostaglandin E2 upon renal function when hypertension appears in the course of chronic renal parenchymatous disease.