Hidden complication: retained cellulose sponge following trabeculectomy with subconjunctival mitomycin C

To report a rare complication of trabeculectomy with adjunctive mitomycin C (MMC) application due to the retention of a cellulose sponge fragment.

A 62-year-old male patient with pseudoexfoliative glaucoma presented with discomfort in the right eye. Examination revealed a retained sponge eroding the conjunctiva, located 4-5 mm posterior to the limbus. The sponge was removed without complications, and topical steroids and antibiotics were prescribed.

The conjunctival area healed spontaneously within 10 days, with complete resolution of inflammation by one month. Follow-up at one year showed no deterioration in bleb formation or increase in intraocular pressure.

This case highlights a rare complication associated with MMC use in glaucoma surgery. It underscores the importance of careful sponge removal to prevent retention and the necessity of close postoperative monitoring to identify complications early.