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The conjunctival edges surrounding the exposed tube were undermined. The old scleral patch graft was dissected and replaced with a new much larger scleral patch graft over the exposed tube. Since there was lack of autologous conjunctiva to cover the new much larger scleral patch graft, we utilized processed dry amniotic membrane (AmnioTek®) to cover the scleral patch graft using a double layer technique described by Ainsworth et al [7]. The first layer of the amniotic membrane (8 x 5 mm) with the epithelium side facing up was draped over the scleral patch graft and its edges tucked under the peripheral undermined conjunctiva. The second larger layer of amniotic membrane (12 x 8 mm) with epithelium side facing down was sutured above the entire area with nylon 10-0 sutures (Figure 2).

Double Layer of Processed Dry Amniotic Membrane for an Exposed Glaucoma Drainage Device Tube