上睑孔结膜蒂皮瓣修复青光眼引流器糜烂

Q3 Medicine

American Journal of Ophthalmology Case Reports Pub Date : 2025-08-30 DOI:10.1016/j.ajoc.2025.102425

Jacob King , John Nguyen , Kevin Halenda

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引用次数: 0

摘要

目的报道一例疑似丝裂霉素c引起的周围结膜组织缺血引起的艾哈迈德青光眼引流装置管腐蚀，并应用穹窿蒂皮瓣成功治疗。观察1例71岁女性患者，既往行丝裂霉素C （MMC）小梁切除术失败，术后1个月行Ahmed青光眼引流装置（GDD）植入术后出现导管糜烂。患者接受了羊膜移植的初步修复。由于7周后迅速、广泛、复发性糜烂，mmcs组织毒性被怀疑是导管暴露的病因。应用穹窿结膜蒂皮瓣重建血管，成功地防止了复发性糜烂。结论及重要性mmc诱导的缺血引起的管侵蚀可引起周围结膜组织的复发性降解，具有感染风险。在大组织缺损和/或血管性差的情况下，孔穴蒂皮瓣重建是修复GDD糜烂的有力技术。

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Glaucoma drainage device erosion rescued with upper eyelid forniceal conjunctival pedicle flap

Purpose

To report a case of Ahmed glaucoma drainage device tube erosion due to suspected mitomycin C-induced ischemia of surrounding conjunctival tissue and its successful management using a forniceal pedicle flap.

Observation

A 71-year-old female with a history of prior failed trabeculectomy with mitomycin C (MMC) presented with tube erosion one month postoperatively following Ahmed glaucoma drainage device (GDD) implantation. The patient underwent primary repair with an amniotic membrane graft. Due to rapid, extensive, recurrent erosion seven weeks later, MMCtissue toxicity was suspected as the etiology of tube exposure. A forniceal conjunctival pedicle flap reconstruction was utilized to reestablish vascularity and successfully prevented recurrent erosion.

Conclusion and importance

Tube erosion due to MMC-induced ischemia may cause recurrent degradation of the surrounding conjunctival tissue, posing an infectious risk. Reconstruction with a forniceal pedicle flap is a powerful technique to repair GDD erosions in the setting of large tissue defects and/or poor vascularity.

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来源期刊

American Journal of Ophthalmology Case Reports Medicine-Ophthalmology

CiteScore

2.40

自引率

0.00%

发文量

513

审稿时长

16 weeks

期刊介绍： The American Journal of Ophthalmology Case Reports is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished case report manuscripts directed to ophthalmologists and visual science specialists. The cases shall be challenging and stimulating but shall also be presented in an educational format to engage the readers as if they are working alongside with the caring clinician scientists to manage the patients. Submissions shall be clear, concise, and well-documented reports. Brief reports and case series submissions on specific themes are also very welcome.