Fig. 1.

Intraoperative images of the use of an amniotic membrane graft (AMG) to bolster an overfiltering trabeculectomy flap. A) A partial thickness scleral flap was created. B) A Kelly punch was used to create a sclerostomy followed by a surgical iridectomy. C) Despite multiple 10-0 nylon sutures, the anterior chamber remain shallow with persistent aqueous efflux through the scleral flap. D) The two components of the fibrin sealant were combined on top of the scleral flap (fibrinogen and thrombin). E) The AMG was peeled carefully from the nitrocellulose support paper F) The AMG was placed over the scleral flap (mesenchymal side down, epithelium side up). G) The conjunctiva was closed over the AMG. H) At the end of the case, the closure was Seidel negative.