title: Trabeculectomy with mitomycin C in refractory glaucoma associated with nonnecrotizing anterior scleritis.
abstract: We report a case of refractory secondary-glaucoma associated with scleritis managed successfully with Mitomycin-C augmented trabeculectomies and preoperative transscleral cyclodiode laser(TSCL). Intraocular pressures (IOPs) were uncontrolled on maximal medical therapy (70mmHgOU).Primary emergency TSCL was performed using reduced parameters whilst optimal immunosuppression was achieved. Uncomplicated elective secondary MMC-trabeculectomies (MMC 0.2mg/ml) were later performed. Over four years postoperative follow-up IOPs have remained within normal range without IOP-lowering medication or bleb manipulations (IOP range 7-14mmHgOU).No scleral melt, scleromalacia or scleritic episodes have occurred postoperatively. This case illustrates that MMC-trabeculectomy and TSCL can be used safely and effectively with appropriate immunosuppression in scleritis-associated secondary glaucoma [corrected].
authors.affiliation: Birmingham and Midland Eye Centre, Birmingham, West Midlands, UK.
authors.forename: Theresa A
authors.initials: TA
authors.lastname: Williams
authors.forename: Freda
authors.initials: F
authors.lastname: Sii
authors.forename: Mark
authors.initials: M
authors.lastname: Chaing
authors.forename: Philip I
authors.initials: PI
authors.lastname: Murray
authors.forename: Peter
authors.initials: P
authors.lastname: Shah
mesh_terms: D000368:Aged; D001684:Biological Dressings; D003228:Conjunctiva / Q000637:transplantation; D016039:Corneal Transplantation; D003320:Corneal Ulcer / Q000209:etiology / Q000628:therapy; D003487:Cyanoacrylates / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D005500:Follow-Up Studies; D005901:Glaucoma / Q000150:complications* / Q000503:physiopathology / Q000628:therapy*; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007429:Intraocular Pressure; D020731:Keratomileusis, Laser In Situ; D008297:Male; D016685:Mitomycin / Q000627:therapeutic use*; D019384:Nucleic Acid Synthesis Inhibitors / Q000627:therapeutic use*; D011183:Postoperative Complications; D011239:Prednisolone / Q000627:therapeutic use; D011625:Pterygium / Q000601:surgery; D012008:Recurrence; D012590:Sclera / Q000637:transplantation; D015423:Scleritis / Q000150:complications* / Q000209:etiology; D014014:Tissue Adhesives / Q000627:therapeutic use; D014130:Trabeculectomy; D014182:Transplantation, Autologous
chemical_list: D003487:Cyanoacrylates; D005938:Glucocorticoids; D019384:Nucleic Acid Synthesis Inhibitors; D014014:Tissue Adhesives; D016685:Mitomycin; D003520:Cyclophosphamide; D011239:Prednisolone