Successful treatment of epithelial downgrowth with endoscopic photocoagulation and intracameral 5-fluorouracil after prolonged limbal wound leak

Abdollah, Zakaria; Zahidin, Aida Zairani Mohd; Ahem, Amin; Rahman, Ropilah Abdul; Din, Norshamsiah Md

doi:10.18240/ijo.2018.04.28

Cited by 1 publication

(1 citation statement)

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“… 3 Several reports have noted successful use of 5-FU. 15 , 16 , 17 , 18 , 19 Sivaraman et al reported three patients with localized epithelial downgrowth treated with partial lamellar sclero-kerato-uvectomy. 20 Yu et al reported successful use of MMC for cystic epithelial downgrowth after cataract surgery.…”

Section: Discussionmentioning

confidence: 99%

Management of severe epithelial versus fibrous downgrowth following trabeculectomy: Case report and literature review

Theophanous

Avdagic

Farooq

et al. 2021

American Journal of Ophthalmology Case Reports

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Purpose To describe the presentation and management of a patient with epithelial versus fibrous downgrowth following trabeculectomy surgery and review relevant literature regarding this complication after intraocular surgery. Observations A 52-year-old monocular African-American woman was referred for management of presumed epithelial versus fibrous downgrowth following trabeculectomy surgery. The patient was initially treated with intracameral injections of 5-fluorouracil (x2) and bevacizumab (x1). Cataract extraction, membranectomy, and a third intracameral 5-fluorouracil injection were performed. Intraocular pressure (IOP) elevation was subsequently managed with a superotemporal Ahmed FP7 glaucoma drainage device in the sulcus, followed by an inferonasal Baerveldt 350 glaucoma drainage device in the sulcus. The downgrowth has not progressed and the intraocular pressure remains controlled at the most recent follow-up. Conclusions This case underscores the risk of this complication following trabeculectomy, the role of a combined medical and surgical approach to management, and the possible need for multiple surgical interventions to control IOP. A review of the literature regarding epithelial and fibrous downgrowth after intraocular surgery was conducted, which highlighted the aggressive nature of these conditions and the range of therapeutic approaches that have been described.

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