Reconstruction of delayed scleral flap melting with bovine pericardium after trabeculectomy with mitomycin C.

Detalhes bibliográficos
Autor(a) principal: Coutinho, I
Data de Publicação: 2017
Outros Autores: Silva, D, Mota, M, Lisboa, M, Trancoso, V, Prieto, I
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10400.10/2009
Resumo: Aim: To present a challenging case of hypotony after trabeculectomy and its treatment. Case description: A 22-year-old woman with juvenile glaucoma underwent a conventional trabeculectomy with mitomycin C on the right eye (OD). In the immediate postoperative period, we observed a hyperfiltration bleb with hypotony refractory to conservative measures leading to hypotony maculopathy. A surgical revision with scleral flap resuture and conjunctival graft was performed with a satisfactory result and resolution of hypotony maculopathy. After two years, the patient complained of low visual acuity (VA) of the OD. During examination, we observed a fine and avascular bleb with Seidel and visualization of the underlying uveal tissue, an intraocular pressure (IOP) of 5 mmHg, and chorioretinal folds. A new revision of the trabeculectomy was performed. During the procedure, it was not possible to identify the scleral flap, so the fistula was closed with a patch of collagenous membrane derived from bovine pericardium (Tutopatch® graft). A good clinical evolution occurred. After 2 months, IOP was 15 mmHg without Seidel or changes in the fundus and VA was 20/20. After 8 months of follow-up, the IOP remains stable without further complaints. Conclusion: This case illustrates the difficulties faced in the management of a common complication of trabeculectomy and highlights some of the options available for its treatment. There are few reports of scleral melting after trabeculectomy. However, trauma and scleral necrosis associated with mitomycin are listed as the main causes. The use of a scleral patch derived from bovine pericardium allows effective suturing and closure of the aqueous leak.
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spelling Reconstruction of delayed scleral flap melting with bovine pericardium after trabeculectomy with mitomycin C.GlaucomaRetinal diseasesTrabeculectomyAim: To present a challenging case of hypotony after trabeculectomy and its treatment. Case description: A 22-year-old woman with juvenile glaucoma underwent a conventional trabeculectomy with mitomycin C on the right eye (OD). In the immediate postoperative period, we observed a hyperfiltration bleb with hypotony refractory to conservative measures leading to hypotony maculopathy. A surgical revision with scleral flap resuture and conjunctival graft was performed with a satisfactory result and resolution of hypotony maculopathy. After two years, the patient complained of low visual acuity (VA) of the OD. During examination, we observed a fine and avascular bleb with Seidel and visualization of the underlying uveal tissue, an intraocular pressure (IOP) of 5 mmHg, and chorioretinal folds. A new revision of the trabeculectomy was performed. During the procedure, it was not possible to identify the scleral flap, so the fistula was closed with a patch of collagenous membrane derived from bovine pericardium (Tutopatch® graft). A good clinical evolution occurred. After 2 months, IOP was 15 mmHg without Seidel or changes in the fundus and VA was 20/20. After 8 months of follow-up, the IOP remains stable without further complaints. Conclusion: This case illustrates the difficulties faced in the management of a common complication of trabeculectomy and highlights some of the options available for its treatment. There are few reports of scleral melting after trabeculectomy. However, trauma and scleral necrosis associated with mitomycin are listed as the main causes. The use of a scleral patch derived from bovine pericardium allows effective suturing and closure of the aqueous leak.GMS. Ophthalmology cases c/o B. Kirchhof c/o Zentrum für Augenheilkunde, Universitätsklinikum KölnRepositório do Hospital Prof. Doutor Fernando FonsecaCoutinho, ISilva, DMota, MLisboa, MTrancoso, VPrieto, I2018-06-18T11:01:15Z2017-01-01T00:00:00Z2017-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.10/2009engGMS Ophthalmol Cases. 2017 Jun 27;7:Doc15.2193-149610.3205/oc000066info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2022-09-20T15:52:43Zoai:repositorio.hff.min-saude.pt:10400.10/2009Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T15:53:01.264988Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Reconstruction of delayed scleral flap melting with bovine pericardium after trabeculectomy with mitomycin C.
title Reconstruction of delayed scleral flap melting with bovine pericardium after trabeculectomy with mitomycin C.
spellingShingle Reconstruction of delayed scleral flap melting with bovine pericardium after trabeculectomy with mitomycin C.
Coutinho, I
Glaucoma
Retinal diseases
Trabeculectomy
title_short Reconstruction of delayed scleral flap melting with bovine pericardium after trabeculectomy with mitomycin C.
title_full Reconstruction of delayed scleral flap melting with bovine pericardium after trabeculectomy with mitomycin C.
title_fullStr Reconstruction of delayed scleral flap melting with bovine pericardium after trabeculectomy with mitomycin C.
title_full_unstemmed Reconstruction of delayed scleral flap melting with bovine pericardium after trabeculectomy with mitomycin C.
title_sort Reconstruction of delayed scleral flap melting with bovine pericardium after trabeculectomy with mitomycin C.
author Coutinho, I
author_facet Coutinho, I
Silva, D
Mota, M
Lisboa, M
Trancoso, V
Prieto, I
author_role author
author2 Silva, D
Mota, M
Lisboa, M
Trancoso, V
Prieto, I
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv Repositório do Hospital Prof. Doutor Fernando Fonseca
dc.contributor.author.fl_str_mv Coutinho, I
Silva, D
Mota, M
Lisboa, M
Trancoso, V
Prieto, I
dc.subject.por.fl_str_mv Glaucoma
Retinal diseases
Trabeculectomy
topic Glaucoma
Retinal diseases
Trabeculectomy
description Aim: To present a challenging case of hypotony after trabeculectomy and its treatment. Case description: A 22-year-old woman with juvenile glaucoma underwent a conventional trabeculectomy with mitomycin C on the right eye (OD). In the immediate postoperative period, we observed a hyperfiltration bleb with hypotony refractory to conservative measures leading to hypotony maculopathy. A surgical revision with scleral flap resuture and conjunctival graft was performed with a satisfactory result and resolution of hypotony maculopathy. After two years, the patient complained of low visual acuity (VA) of the OD. During examination, we observed a fine and avascular bleb with Seidel and visualization of the underlying uveal tissue, an intraocular pressure (IOP) of 5 mmHg, and chorioretinal folds. A new revision of the trabeculectomy was performed. During the procedure, it was not possible to identify the scleral flap, so the fistula was closed with a patch of collagenous membrane derived from bovine pericardium (Tutopatch® graft). A good clinical evolution occurred. After 2 months, IOP was 15 mmHg without Seidel or changes in the fundus and VA was 20/20. After 8 months of follow-up, the IOP remains stable without further complaints. Conclusion: This case illustrates the difficulties faced in the management of a common complication of trabeculectomy and highlights some of the options available for its treatment. There are few reports of scleral melting after trabeculectomy. However, trauma and scleral necrosis associated with mitomycin are listed as the main causes. The use of a scleral patch derived from bovine pericardium allows effective suturing and closure of the aqueous leak.
publishDate 2017
dc.date.none.fl_str_mv 2017-01-01T00:00:00Z
2017-01-01T00:00:00Z
2018-06-18T11:01:15Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10400.10/2009
url http://hdl.handle.net/10400.10/2009
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv GMS Ophthalmol Cases. 2017 Jun 27;7:Doc15.
2193-1496
10.3205/oc000066
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv GMS. Ophthalmology cases c/o B. Kirchhof c/o Zentrum für Augenheilkunde, Universitätsklinikum Köln
publisher.none.fl_str_mv GMS. Ophthalmology cases c/o B. Kirchhof c/o Zentrum für Augenheilkunde, Universitätsklinikum Köln
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
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reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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