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Iatrogenic Bleb Formation and Hypotony Maculopathy Following Pterygium Surgery with Mitomycin-C

PURPOSE: To report a case of late iatrogenic bleb formation and hypotony maculopathy after pterygium surgery applying Mitomycin C (MMC). CASE REPORT: A 66-year-old man presented with an elevated, bleb-like, fluid-filled, cystic lesion on the nasal sclera of the right eye. The patient had undergone p...

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Autores principales: Shokouhi-Rad, Saeed, Alizadeh, Reza, Daneshvar, Ramin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4687272/
https://www.ncbi.nlm.nih.gov/pubmed/26730324
http://dx.doi.org/10.4103/2008-322X.170341
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author Shokouhi-Rad, Saeed
Alizadeh, Reza
Daneshvar, Ramin
author_facet Shokouhi-Rad, Saeed
Alizadeh, Reza
Daneshvar, Ramin
author_sort Shokouhi-Rad, Saeed
collection PubMed
description PURPOSE: To report a case of late iatrogenic bleb formation and hypotony maculopathy after pterygium surgery applying Mitomycin C (MMC). CASE REPORT: A 66-year-old man presented with an elevated, bleb-like, fluid-filled, cystic lesion on the nasal sclera of the right eye. The patient had undergone pterygium surgery with a combination of conjunctival autograft and adjuvant intraoperative MMC 0.02% four years before. The sclera seemed fistulized at the site of surgery and a thin layer of conjunctiva completely covered the lesion. A scleral patch graft was secured over the fistula with sutures, followed by excision of the thinned, avascular conjunctiva and advancement of the healthy adjacent conjunctiva to cover the patch graft. One month later, a small bleb re-appeared adjacent to the scleral patch graft and IOP was 2 mmHg. Argon-laser treatment of the bleb was tried to induce scarring and reduction of bleb size, and was highly effective. After one week, IOP was increased to 8 mmHg. The clinical features remained stable four months after initial presentation. CONCLUSION: Pterygium surgery using adjuvant MMC may result in late iatrogenic bleb formation and hypotony maculopathy. This complication can be successfully corrected surgically using a scleral patch graft combined with argon laser treatment over the inadvertent bleb.
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spelling pubmed-46872722016-01-04 Iatrogenic Bleb Formation and Hypotony Maculopathy Following Pterygium Surgery with Mitomycin-C Shokouhi-Rad, Saeed Alizadeh, Reza Daneshvar, Ramin J Ophthalmic Vis Res Case Report PURPOSE: To report a case of late iatrogenic bleb formation and hypotony maculopathy after pterygium surgery applying Mitomycin C (MMC). CASE REPORT: A 66-year-old man presented with an elevated, bleb-like, fluid-filled, cystic lesion on the nasal sclera of the right eye. The patient had undergone pterygium surgery with a combination of conjunctival autograft and adjuvant intraoperative MMC 0.02% four years before. The sclera seemed fistulized at the site of surgery and a thin layer of conjunctiva completely covered the lesion. A scleral patch graft was secured over the fistula with sutures, followed by excision of the thinned, avascular conjunctiva and advancement of the healthy adjacent conjunctiva to cover the patch graft. One month later, a small bleb re-appeared adjacent to the scleral patch graft and IOP was 2 mmHg. Argon-laser treatment of the bleb was tried to induce scarring and reduction of bleb size, and was highly effective. After one week, IOP was increased to 8 mmHg. The clinical features remained stable four months after initial presentation. CONCLUSION: Pterygium surgery using adjuvant MMC may result in late iatrogenic bleb formation and hypotony maculopathy. This complication can be successfully corrected surgically using a scleral patch graft combined with argon laser treatment over the inadvertent bleb. Medknow Publications & Media Pvt Ltd 2015 /pmc/articles/PMC4687272/ /pubmed/26730324 http://dx.doi.org/10.4103/2008-322X.170341 Text en Copyright: © 2015 Journal of Ophthalmic and Vision Research http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Case Report
Shokouhi-Rad, Saeed
Alizadeh, Reza
Daneshvar, Ramin
Iatrogenic Bleb Formation and Hypotony Maculopathy Following Pterygium Surgery with Mitomycin-C
title Iatrogenic Bleb Formation and Hypotony Maculopathy Following Pterygium Surgery with Mitomycin-C
title_full Iatrogenic Bleb Formation and Hypotony Maculopathy Following Pterygium Surgery with Mitomycin-C
title_fullStr Iatrogenic Bleb Formation and Hypotony Maculopathy Following Pterygium Surgery with Mitomycin-C
title_full_unstemmed Iatrogenic Bleb Formation and Hypotony Maculopathy Following Pterygium Surgery with Mitomycin-C
title_short Iatrogenic Bleb Formation and Hypotony Maculopathy Following Pterygium Surgery with Mitomycin-C
title_sort iatrogenic bleb formation and hypotony maculopathy following pterygium surgery with mitomycin-c
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4687272/
https://www.ncbi.nlm.nih.gov/pubmed/26730324
http://dx.doi.org/10.4103/2008-322X.170341
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