Corneal endothelial damage after trabeculectomy with mitomycin C in two patients with glaucoma with cornea guttata

Cornea
Takeo FukuchiHaruki Abe

Abstract

To report two patients with glaucoma who exhibited severe damage to the corneal endothelium after a trabeculectomy with mitomycin C (MMC). This study includes clinical histories and specular microscopic pictures of the cases. Both patients were middle-aged women, 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 2 to 5 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 preexisting cornea guttata, the flat anterior chamber, and possibly the administration of MMC. 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.

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Citations

Jun 9, 2005·Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Für Klinische Und Experimentelle Ophthalmologie·Holger MietzGünter K Krieglstein
May 14, 2010·Clinical Ophthalmology·Takeo FukuchiHaruki Abe
Mar 7, 2006·Journal of Cataract and Refractive Surgery·Rodrigo M TorresJosé Bernal
Jan 18, 2011·American Journal of Ophthalmology·Ahmad KheirkhahMahmoud Jabbarvand Behrouz
Apr 3, 2019·European Journal of Ophthalmology·Shmuel GraffiDan D Gaton
Dec 27, 2019·Journal of Glaucoma·Andrew S Camp, Robert N Weinreb
May 29, 2007·Journal of Cataract and Refractive Surgery·Walter C HellingerUNKNOWN ASCRS Ad Hoc Task Force on Cleaning and Sterilization of Intraocular Instruments
Nov 21, 2009·European Journal of Ophthalmology·N Demet OzcelikBurak Bilgin
Mar 1, 2017·Journal of Korean Medical Science·Wool SuhJae Ryong Han
Jul 31, 2003·Current Opinion in Ophthalmology·C H Parikh, H F Edelhauser
Sep 2, 2021·Journal of Cataract and Refractive Surgery·Preeya K GuptaUNKNOWN from the ASCRS Cornea Clinical Committee

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