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Molteno rip-cord suture hypopyon
S F Ball1, K Loftfield, J Scharfenberg
1Department of Ophthalmology, Louisiana State University Medical Center School of Medicine, New Orleans 70112.
Abstract:
Seven of 27 eyes developed hypopyons following removal of a 4-0 chromic suture that had been placed intraoperatively in the lumen of the tube of a Molteno implant as a temporary occlusion device. The hypopyons were sterile to anterior chamber tap and in six of seven cases resolved with only routine antibiotic coverage. Surgeons contemplating using an internal chromic suture occlusion in Molteno implants, however, should be aware of this potential problem and adopt a conservative, noninvasive approach.
Insights
A temporary internal chromic suture in Molteno implants can lead to sterile hypopyons. Most cases resolved with antibiotics, but surgeons should consider this risk.
Area of Science:
- Ophthalmology
- Surgical Innovation
- Glaucoma Drainage Devices
Background:
- Molteno implants are used to treat refractory glaucoma.
- Temporary occlusion of the implant tube lumen is sometimes employed during surgery.
Observation:
- A 4-0 chromic suture was used intraoperatively to occlude the Molteno implant tube lumen.
- Seven out of 27 eyes developed hypopyons after suture removal.
Findings:
- The hypopyons observed were sterile upon anterior chamber paracentesis.
- Six of the seven affected eyes resolved with standard antibiotic treatment alone.
Implications:
- Surgeons should be aware of the potential for sterile hypopyons when using internal chromic sutures in Molteno implants.
- A conservative, noninvasive management approach is recommended for this complication.