Focal corneal decompensation after filtering surgery with mitomycin C

Area of Science:

• Ophthalmology
• Surgical Complications
• Corneal Diseases

Background:

• Glaucoma filtering surgery is a common procedure to reduce intraocular pressure (IOP).
• Mitomycin C (MMC) is frequently used as an adjunct to enhance surgical outcomes.
• Corneal complications, though rare, can significantly impact visual function post-surgery.

Observation:

• A 25-year-old male presented with photophobia and was diagnosed with idiopathic bilateral granulomatous anterior uveitis.
• The left eye developed refractory ocular hypertension requiring filtering surgery with 0.02% MMC.
• Postoperatively, the inferior cornea exhibited significant edema due to endothelial dysfunction, despite successful IOP control.

Findings:

• The patient developed focal corneal decompensation in the inferior third of the cornea.
• This complication was attributed to inadvertent inadequate irrigation of mitomycin C (MMC) during the filtering procedure.
• Severe endothelial dysfunction was the direct cause of the corneal edema.

Implications:

• Thorough and adequate irrigation of mitomycin C (MMC) is crucial during filtering surgery.
• Inadequate MMC irrigation can result in serious ocular complications, including corneal decompensation.
• This case underscores the need for meticulous surgical technique to prevent iatrogenic corneal damage.