Trabeculectomy with mitomycin C in refractory glaucoma associated with nonnecrotizing anterior scleritis.
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].
Williams
Theresa A
TA
Birmingham and Midland Eye Centre, Birmingham, West Midlands, UK.
Sii
Freda
F
Chaing
Mark
M
Murray
Philip I
PI
Shah
Peter
P
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
D003487:Cyanoacrylates; D005938:Glucocorticoids; D019384:Nucleic Acid Synthesis Inhibitors; D014014:Tissue Adhesives; D016685:Mitomycin; D003520:Cyclophosphamide; D011239:Prednisolone