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Scleral burn and perforation following transscleral cyclophotocoagulation

PURPOSE: This case report highlights scleral perforation as a complication of diode laser transscleral cyclophotocoagulation in the treatment of refractory primary open-angle glaucoma, as well as the management of this complication. OBSERVATIONS: A 78-year-old woman with primary open-angle glaucoma...

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Autores principales: Billings, Beau, Fletcher, Drew B., Weaver, Alex C., Alkaelani, Mohammad Tahseen, Fallgatter, Kyle, Daneshvar, Ramen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10496012/
https://www.ncbi.nlm.nih.gov/pubmed/37705756
http://dx.doi.org/10.1016/j.ajoc.2023.101893
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author Billings, Beau
Fletcher, Drew B.
Weaver, Alex C.
Alkaelani, Mohammad Tahseen
Fallgatter, Kyle
Daneshvar, Ramen
author_facet Billings, Beau
Fletcher, Drew B.
Weaver, Alex C.
Alkaelani, Mohammad Tahseen
Fallgatter, Kyle
Daneshvar, Ramen
author_sort Billings, Beau
collection PubMed
description PURPOSE: This case report highlights scleral perforation as a complication of diode laser transscleral cyclophotocoagulation in the treatment of refractory primary open-angle glaucoma, as well as the management of this complication. OBSERVATIONS: A 78-year-old woman with primary open-angle glaucoma refractory to medication had transscleral cyclophotocoagulation performed in her left eye. During the procedure, it was noted that conjunctival burns and scleral perforation had occurred, at which point the procedure was aborted. Limited peritomy and patch graft with split-thickness donor cornea was done in the area of the scleral thinning and perforation. The patient had a good outcome with an intraocular pressure of 8 mm Hg, appropriate integration of the patch graft, and no significant conjunctival inflammation at the 2-month post-operative visit. CONCLUSIONS AND IMPORTANCE: This patient, without any known risk factors for scleral thinning or necrosis, experienced conjunctival burn as well as scleral perforation during transscleral cyclophotocoagulation, underscoring this possible complication of the procedure. Additionally, split-thickness donor cornea was used to patch graft the area of scleral thinning and perforation, which is a method of managing this complication that had not been previously reported.
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spelling pubmed-104960122023-09-13 Scleral burn and perforation following transscleral cyclophotocoagulation Billings, Beau Fletcher, Drew B. Weaver, Alex C. Alkaelani, Mohammad Tahseen Fallgatter, Kyle Daneshvar, Ramen Am J Ophthalmol Case Rep Case Report PURPOSE: This case report highlights scleral perforation as a complication of diode laser transscleral cyclophotocoagulation in the treatment of refractory primary open-angle glaucoma, as well as the management of this complication. OBSERVATIONS: A 78-year-old woman with primary open-angle glaucoma refractory to medication had transscleral cyclophotocoagulation performed in her left eye. During the procedure, it was noted that conjunctival burns and scleral perforation had occurred, at which point the procedure was aborted. Limited peritomy and patch graft with split-thickness donor cornea was done in the area of the scleral thinning and perforation. The patient had a good outcome with an intraocular pressure of 8 mm Hg, appropriate integration of the patch graft, and no significant conjunctival inflammation at the 2-month post-operative visit. CONCLUSIONS AND IMPORTANCE: This patient, without any known risk factors for scleral thinning or necrosis, experienced conjunctival burn as well as scleral perforation during transscleral cyclophotocoagulation, underscoring this possible complication of the procedure. Additionally, split-thickness donor cornea was used to patch graft the area of scleral thinning and perforation, which is a method of managing this complication that had not been previously reported. Elsevier 2023-07-09 /pmc/articles/PMC10496012/ /pubmed/37705756 http://dx.doi.org/10.1016/j.ajoc.2023.101893 Text en © 2023 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Billings, Beau
Fletcher, Drew B.
Weaver, Alex C.
Alkaelani, Mohammad Tahseen
Fallgatter, Kyle
Daneshvar, Ramen
Scleral burn and perforation following transscleral cyclophotocoagulation
title Scleral burn and perforation following transscleral cyclophotocoagulation
title_full Scleral burn and perforation following transscleral cyclophotocoagulation
title_fullStr Scleral burn and perforation following transscleral cyclophotocoagulation
title_full_unstemmed Scleral burn and perforation following transscleral cyclophotocoagulation
title_short Scleral burn and perforation following transscleral cyclophotocoagulation
title_sort scleral burn and perforation following transscleral cyclophotocoagulation
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10496012/
https://www.ncbi.nlm.nih.gov/pubmed/37705756
http://dx.doi.org/10.1016/j.ajoc.2023.101893
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