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Abstract #3671 Published in IGR 4-2
Corneal endothelial damage after trabeculectomy with mitomycin C in two patients with glaucoma with cornea guttata
Fukuchi T; Hayakawa Y; Hara H; Abe HCornea 2002; 21: 300-304
PURPOSE: To report two patients with glaucoma who exhibited severe damage to the corneal endothelium after a trabeculectomy with mitomycin C (MMC). METHODS: This study includes clinical histories and specular microscopic pictures of the cases. RESULTS: Both patients were middle-aged females, who underwent trabeculectomy with MMC, had moderate to severe cornea guttata preoperatively, and developed a shallow to flat anterior chamber, classified as grade 2 according to Spaeth early in the postoperative period. Stromal opacity caused by corneal edema associated with severe Descemet's membrane folds appeared within two to five days in both cases. The density of the corneal endothelium was decreased on specular microscopic examination. The severe corneal endothelial damage seen after the trabeculectomy with MMC was likely owing to a combination of the pre-existing cornea guttata, the flat anterior chamber, and possibly the administration of MMC. CONCLUSIONS: Severe endothelial damage after trabeculectomy with MMC may occur in patients with glaucoma and associated cornea guttata. The use of tight sutures on the scleral flap or a modified operative method, nonpenetrating trabeculectomy, may be effective in preventing a shallow to flat anterior chamber postoperatively.
Dr. T. Fukuchi, Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan. tfuku@med.niigata-u.ac.jp
Classification:
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)