Corneal lamellar grafting to repair late complications of mitomycin C trabeculectomy

Abstract

Takeo Fukuchi, Hidenobu Matsuda, Jun Ueda, Akiko Yamada, Kieko Suda, Haruki AbeDivision of Ophthalmology and Visual Science, Graduated School of Medical and Dental Sciences, Niigata University, Niigata, JapanPurpose: To report corneal lamellar grafting to repair the late-onset complications after MMC trabeculectomy.Methods: Multiple case reports.Results: A 76-year-old male with primary open-angle glaucoma (POAG) and a 55-year-old male with late developmental glaucoma complicated by bleb leaks from a microhole 10 and eight years after surgery, respectively. Severe ciliochoroidal detachment and a shallow anterior chamber were persistent in one case and bleb-related infection recurred in another. Additionally, a 46-year-old male with POAG had hypotony maculopathy with a giant ischemic bleb 18 months after surgery. Although these patients were quite resistant to medical and surgical treatments, they were successfully treated by corneal lamellar grafting without complications. Conclusions: Tectonic corneal lamellar grafting is a reliable and final surgical method to improve severe cases of hypotony maculopathy or bleb leak after mitomycin C trabeculectomy.Keywords: mitomycin C, trabeculectomy, postoperative complications, hypotony maculopathy, bleb leak, corneal lamellar grafting