摘要
Background: Bleb related inflammation following trabeculectomy is usually seen in the late post operative period and is unusual in the first 6 months after su rgery We report the clinical findings and course of two patients with early bleb related inflammation secondary to retained cellulose sponge fragments used to a pply mitomycin C on the scleral surface. Methods: Retrospective review of medica l records of two patients and pathology from one patient. Results: Both patients developed bleb related inflammation four months after a combined fornix based t rabeculectomy and cataract procedure in which mitomycin C was applied using filt er paper discs (Whatman filter paper #1). Material suggestive of cellulose frag ments was noted in the filtering bleb in both patients. Patient 1 had a bleb lea k at time of presentation and pathologic examination of foreign body material ob tained from the site of the leak demonstrated a granulomatous reaction surroundi ng cellulose fibers. The foreign body material was removed in both patients. Thi s led to resolution of the bleb leak in the first patient and at one year follow ing the procedure both patients had functioning blebs in the affected eye. Concl usions: Retention of sponge fragments is rare but may be a cause of bleb inflamm ation as a result of a foreign body granulomatous reaction. The choice of sponge material that does not shred may help in avoiding this unusual complication.
Background: Bleb related inflammation following trabeculectomy is usually seen in the late post operative period and is unusual in the first 6 months after su rgery We report the clinical findings and course of two patients with early bleb related inflammation secondary to retained cellulose sponge fragments used to a pply mitomycin C on the scleral surface. Methods: Retrospective review of medica l records of two patients and pathology from one patient. Results: Both patients developed bleb related inflammation four months after a combined fornix based t rabeculectomy and cataract procedure in which mitomycin C was applied using filt er paper discs (Whatman filter paper #1). Material suggestive of cellulose frag ments was noted in the filtering bleb in both patients. Patient 1 had a bleb lea k at time of presentation and pathologic examination of foreign body material ob tained from the site of the leak demonstrated a granulomatous reaction surroundi ng cellulose fibers. The foreign body material was removed in both patients. Thi s led to resolution of the bleb leak in the first patient and at one year follow ing the procedure both patients had functioning blebs in the affected eye. Concl usions: Retention of sponge fragments is rare but may be a cause of bleb inflamm ation as a result of a foreign body granulomatous reaction. The choice of sponge material that does not shred may help in avoiding this unusual complication.
出处
《世界核心医学期刊文摘（眼科学分册）》
2005年第8期55-56,共2页
Digest of the World Core Medical Journals:Ophthalmology
