Treatment of Hypotonous Maculopathy After Trabeculectomy With Mitomycin C

Nuyts, Rudy M. M. A.; Greve, E. L.; Geijssen, H. Caroline; Langerhorst, C. T.

doi:10.1016/s0002-9394(14)72956-3

Cited by 85 publications

(48 citation statements)

References 19 publications

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“…In cases in which aqueous drainage is still excessive, it is extremely difficult to re-form the anterior chamber. To improve on this, autologous blood injection, which recently was introduced [7,8], is useful, but decreased visual acuity, cosmetic complications, and marked intraocular pressure increases [9,10] sometimes oc cur. To prevent excessive drainage, if the suture is too tight, laser suturelysis [11] must be performed.…”

Section: Resultsmentioning

confidence: 99%

Trabeculectomy with a Kelly Descemet Membrane Punch

Suzuki

1997

Ophthalmologica

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The trabeculectomy procedure was modified with the introduction of the Kelly Descemet membrane punch. Using this punch, a few limbal tissue sections (0.25 ×0.30 mm) were easily excised from beneath the scleral flap base. Mitomycin C (MMC) was used. Among the 100 most recent operations in which this punch was used, no patients developed severe shallow anterior chambers over ten days. Because MMC is so effective and active for a long period, small excision surgery using this punch should be reconsidered.

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Section: Resultsmentioning

confidence: 99%

Trabeculectomy with a Kelly Descemet Membrane Punch

Suzuki

1997

Ophthalmologica

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“…The benefit of either intrableb or peribleb blood injection after filtering surgery for cases of hypotonous maculopathy which results from either leaking blebs or overfiltering has been noted (Wise 1993;Nuyts et al 1994;Leen et al 1995;Smith et al 1995). Some clinicians reported that peribleb blood injection (Smith et al 1995) might be safer than intrableb injection to decrease the incidence of hyphema (Leen 1996), which could cause visionthreatening complications (Lu et al 1997).…”

Section: Discussionmentioning

confidence: 99%

“…It is well-known, however, that occlusion of the trabecular meshwork with a viscoelastic agent increases IOP (Percival 1982). Some patients received viscoelastic injection intracamerally before blood injection had an IOP peak (McCoy & Burney 1998;Nuyts et al 1994). In glaucomatous eyes with severe visual field loss, IOP spikes can cause deterioration in visual acuity (Savage et al 1985).…”

Section: Discussionmentioning

confidence: 99%

Autologous blood injection for marked overfiltration early after trabeculectomy with mitomycin C

Okada

Tsukamoto

Masumoto

et al. 2001

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: After trabeculectomy with mitomycin C, extremely low intraocular pressure (IOP) with excess filtration may cause hypotonous maculopathy in the early postoperative period. We evaluated the effect of injecting autologous blood on reversing early postoperative marked hypotony after trabeculectomy with mitomycin C. Methods: Trabeculectomy with mitomycin C was performed in 258 eyes between 1994 and 1998. Peribleb autologous blood injection was performed in five eyes in which pressure patches were ineffective in reversing excess filtration. Approximately 0.1 to 0.3 ml of whole unclotted blood was slowly injected at least 3 mm from the edge of the flap using a sterile 27-gauge needle. Results: None of these eyes developed hypotonous maculopathy after injection. After a mean 31-month follow-up, all eyes had well-controlled IOP and visual acuity in three eyes was much improved. Postoperative complications included mild IOP elevation in one eye treated with laser suturelysis, and fibrinous pupillary membrane in one eye. Conclusion: In the early postoperative period, autologous blood injection is effective in reversing excess filtration.

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“…There have been numerous studies describing success with mitomycin C in concentrations varying between 0.1 mg/ml and 0.5 mg/ml and exposure times varying from 1 to 5 minutes [14][15][16][17][18] . There are also many accounts of increased complications of mitomycin C filtering surgery including hypotony 15,17,18 .…”

Section: Discussionmentioning

confidence: 99%

Persistent hypotony after primary trabeculectomy with mitomycin C

Guedes

Simmons

Pakter

et al. 2000

Arq. Bras. Oftalmol.

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Persistent hypotony after primary trabeculectomy with mitomycin C Purpose: To describe the clinical findings and treatment modalities of persistent hypotony following primary trabeculectomy with mitomycin C.Methods: We retrospectively analyzed 9 eyes with persistent hypotony, which was defined as intraocular pressure less than or equal to 5 mmHg for more than 2 months.Results: Mean hypotony duration was 7.4 months (standard deviation (SD) ± 6.7 months, range 2 to 23 months). Associated findings included choroidal detachment (2 eyes) and maculopathy (5 eyes). All patients who developed maculopathy were relatively young (mean age = 37 years old, SD ± 16, range 18 to 79 years). Treatments included bandaged contact lens, autologous blood injection, phacoemulsification, resuturing of the scleral flap, scleral patch graft, and Simmons' shell. After treatment, intraocular pressure (IOP) raised in all patients (mean final IOP = 11.1 mmHg, SD ± 3.5). On the first day of hypotony, the mean IOP was 3 mmHg (SD ±1.7). At the last follow up, visual acuity (VA) was unchanged in 3 eyes, worsened in 2 eyes (by 2 Snellen lines), and improved (by 1 to 4 Snellen lines) in 4 eyes. Of those eyes whose VA improved, 3 had undergone phacoemulsification.Conclusion: Hypotony after trabeculectomy with mitomycin C can be reversed with possible improvement in vision. Hipotonia persistente depois de trabeculectomia primária com mitomicina C

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Treatment of Hypotonous Maculopathy After Trabeculectomy With Mitomycin C

Cited by 85 publications

References 19 publications

Trabeculectomy with a Kelly Descemet Membrane Punch

Trabeculectomy with a Kelly Descemet Membrane Punch

Autologous blood injection for marked overfiltration early after trabeculectomy with mitomycin C

Persistent hypotony after primary trabeculectomy with mitomycin C

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