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1998•Journal of GlaucomaRequires access

Delayed Corneal Epitheliopathy After Antimetabolite-Augmented Trabeculectomy

Edward E. Manche, Mehran A. Afshari, Kuldev Singh

Open publisher page 28 citations

Abstract

PURPOSE: The authors describe the first case of delayed antimetabolite-related corneal epithelial toxicity after trabeculectomy and its successful treatment with limbal stem cell transplantation. METHODS: A 73-year-old woman underwent trabeculectomy with intraoperative mitomycin C. After surgery she received six 5-mg injections of subconjunctival 5-fluorouracil (5-FU) adjacent to the bleb. RESULTS: The patient had a functioning trabeculectomy and clear cornea until 30 months after surgery, at which time she developed a nonhealing superior corneal epithelial defect. After 4 months of conservative medical management, an autologous limbal stem cell transplantation was performed. The epithelial defect resolved completely within 1 week of limbal stem cell transplantation. CONCLUSIONS: Delayed corneal epithelial toxicity may be a late complication of antimetabolite-augmented trabeculectomy.

About this research paper

What this paper is about

PURPOSE: The authors describe the first case of delayed antimetabolite-related corneal epithelial toxicity after trabeculectomy and its successful treatment with limbal stem cell transplantation. METHODS: A 73-year-old woman underwent trabeculectomy with intraoperative mitomycin C. After surgery she received six 5-mg injections of subconjunctival 5-fluorouracil (5-FU) adjacent to the bleb. RESULTS: The patient had a functioning trabeculectomy and clear cornea until 30 months after surgery, at which time she developed a nonhealing superior corneal epithelial defect. After 4 months of conservative medical management, an autologous limbal stem cell transplantation was performed. The epithelial defect resolved completely within 1 week of limbal stem cell transplantation. CONCLUSIONS: Delayed corneal epithelial toxicity may be a late complication of antimetabolite-augmented trabeculectomy.

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Available abstract

PURPOSE: The authors describe the first case of delayed antimetabolite-related corneal epithelial toxicity after trabeculectomy and its successful treatment with limbal stem cell transplantation. METHODS: A 73-year-old woman underwent trabeculectomy with intraoperative mitomycin C. After surgery she received six 5-mg injections of subconjunctival 5-fluorouracil (5-FU) adjacent to the bleb. RESULTS: The patient had a functioning trabeculectomy and clear cornea until 30 months after surgery, at which time she developed a nonhealing superior corneal epithelial defect. After 4 months of conservative medical management, an autologous limbal stem cell transplantation was performed. The epithelial defect resolved completely within 1 week of limbal stem cell transplantation. CONCLUSIONS: Delayed corneal epithelial toxicity may be a late complication of antimetabolite-augmented trabeculectomy.

Key concepts: Trabeculectomy, Antimetabolite, Medicine, Transplantation, Cornea, Surgery, Mitomycin C, Ophthalmology

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