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TitreSurgical technique for scleral melting 14 years after trabeculectomy with Mitomycin C.
Abstract Nr.1037
ButA 81 year old female patient presented with persistent blebitis and endophthalmitis in the left eye. The cornea and sclera superior showed melting. In 2001, she underwent a trabeculectomy with Mitomycin C in the same eye.
MéthodesSurgical repair using a donor sclera was done. First, the conjunctiva was dissected over the melted sclera. Donor sclera (11mm limbal, 17 mm posterior, 13 mm temporal and 15 mm nasally) was prepared and tissue glue was used to attach it to the host sclera. Additionally, the sclera was anchored with Nylon 10-0 sutures nasally and temporally. A conjunctival autograft slightly larger than the scleral graft was dissected inferiorly to cover the scleral patch. The conjunctiva was attached to the limbus with Nylon 10-0 sutures and posteriorly with Vicryl 9-0. The patient was instructed to apply a fixed combination of tobramycin and dexamethasone eye drops four times daily.
RésultatsInitially, the endophthalmitis resolved fast. A minor dellen formation was under control with lubricants. There was a little flare up of the intra-ocular inflammation after the cessation of the topical cortisone drops which was immediately under control after resuming the therapy. Her preoperative visual acuity was counting fingers, which did not change after surgery.
ConclusionA successful scleral reinforcement using donor sclera was performed in a 81 year old female patient with persistent blebitis and endophthalmitis after trabeculectomy with Mitomycin C 14 years ago.
Auteur 1
NomDELBEKE
InitialesH
InstitutUZ Leuven
VilleLeuven
Auteur 2
NomVandewalle
InitialesE
InstitutUZ Leuven
VilleLeuven
Auteur 3
NomHua
InitialesMT
InstitutUZ Leuven
VilleLeuven
Auteur 4
NomStalmans
InitialesI
InstitutUZ Leuven
VilleLeuven
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