Abstract:
PURPOSE:To report two patients with glaucoma who exhibited severe damage to the corneal endothelium after a trabeculectomy with mitomycin C (MMC). METHODS:This study includes clinical histories and specular microscopic pictures of the cases. RESULTS:Both patients were middle-aged women, underwent trabeculectomy with MMC, had moderate to severe cornea guttata preoperatively, and developed a shallow to flat anterior chamber, classified as grade 2 according to Spaeth early in the postoperative period. Stromal opacity caused by corneal edema associated with severe Descemet's membrane folds appeared within 2 to 5 days in both cases. The density of the corneal endothelium was decreased on specular microscopic examination. The severe corneal endothelial damage seen after the trabeculectomy with MMC was likely owing to a combination of the preexisting cornea guttata, the flat anterior chamber, and possibly the administration of MMC. CONCLUSION:Severe endothelial damage after trabeculectomy with MMC may occur in patients with glaucoma and associated cornea guttata. The use of tight sutures on the scleral flap or a modified operative method, nonpenetrating trabeculectomy, may be effective in preventing a shallow to flat anterior chamber postoperatively.
journal_name
Corneajournal_title
Corneaauthors
Fukuchi T,Hayakawa Y,Hara H,Abe Hdoi
10.1097/00003226-200204000-00012subject
Has Abstractpub_date
2002-04-01 00:00:00pages
300-4issue
3eissn
0277-3740issn
1536-4798journal_volume
21pub_type
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