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Abstract #15486 Published in IGR 1-3
Visual loss after primary trabeculectomy with mitomycine-C in Ehlers-Danlos syndrome
Cordeiro MF; Plant GT; Child A; Jones B; Khaw PTBritish Journal of Ophthalmology 1999; 83: 1194-1196
This is a report of a twelve year old girl with glaucoma who had bilateral trabeculectomies with mitomycine-C. Five months after her fitration surgery she developed a hypotony and a severe decrease of visual acuity in both eyes. The pressures were zero mmHg. There was severe edema in the back of the eye including swollen optic discs. After some other interventions both blebs had scleral patch grafts. Her pressures rose to 20 mmHg and visual acuity improved. Later on pressures rose to even higher levels and needling was necessary. At the end of the report pressures were under 20 mmHg and visual acuity had returned to 20/30 and 20/120 respectively. Only than the diagnosis of Ehlers-Danlos was made in this girl. The point made by these authors is that the use of mitomycine-C may be dangerous in patients with connective tissue disorders like Ehlers-Danlos syndrome. The woundhealing process in this disease is known to be abnormal in the skin because of the anomalous development of scar formation due to aberrant collagen fiber. The authors suppose that the abnormal healing respons to filtering surgery may have exaggerated the effects of mitomycine-C. The authors suggests that anti-proliferatives should be used with extreme caution in patients with connective tissue disorder.
M.F.Cordeiro, Institute of Ophthalmology and Moorfields Eye Hospital, London
Classification:
9.4.15 Glaucoma in relation to systemic disease (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
