Extensive Submacular Hemorrhage After Trabeculectomy With Mitomycin C.

Area of Science:

• Ophthalmology
• Retinal Diseases
• Glaucoma Surgery

Background:

• A patient with primary open-angle glaucoma and age-related macular degeneration with occult choroidal neovascular membrane (CNVM) underwent trabeculectomy with mitomycin C due to uncontrolled intraocular pressure.
• The patient had a history of multiple intravitreal injections for the CNVM.

Observation:

• Postoperatively, the patient developed an extensive subretinal hemorrhage despite controlled intraocular pressure and a well-formed bleb.
• The hemorrhage required surgical intervention (pneumatic displacement and pars plana vitrectomy).

Findings:

• The patient experienced significant visual acuity loss and developed extensive subretinal fibrosis 7 months post-surgery.
• This is the first reported instance of extensive submacular hemorrhage after trabeculectomy with mitomycin C in a patient with an occult CNVM.

Implications:

• This case underscores the importance of considering underlying choroidal neovascularization when performing glaucoma surgery.
• Further research may be needed to identify risk factors and preventative strategies for this complication.