A patient presented to the BPEI emergency room with blurry vision and pain of both eyes for 1 week. The patient had a history of Xen gel stents with injection of 0.1ml 0.04mg/mL mitomycin-C, as well as revision of both blebs with injection of triamcinolone and mitomycin-C, in both eyes within the previous year. Within the previous two months, patient had Ahmed glaucoma tube shunt placed superotemporally in each eye. Examination revealed 20/40 vision in both eyes, intraocular pressure of 12 on the right, 21 on the left. In both eyes, there was exposure of the superotemporal Ahmed tube shunt in both eyes adjacent to the superior Xen gel stent, surrounded by white ischemic conjunctiva. The patient underwent revision of the right eye tube, with amputation of the tube and amniotic membrane. Endosccopic cyclophotocoagulation of the right eye was also done at that time. The left eye underwent revision of tube exposure with covering of the existing tube with a corneal patch graft and conjunctiva. Treatment with antimetabolites increases the success of glaucoma surgery, but also increases risk of leak and exposures.
Presentation Date: 06/10/2021
Issue Date: 06/18/2021