Late-Onset Inadvertent Bleb Formation following Pars Plana M3 Molteno Implant Tube Obstruction
Purpose: To report a case of inadvertent bleb formation presenting 18 months after pars plana M3 Molteno implant tube obstruction in a patient with mixed mechanism glaucoma. Materials and Methods: An 84-year-old Caucasian male with mixed mechanism glaucoma underwent slit-lamp examination, gonioscopy...
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| Format: | Article |
| Language: | English |
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Karger Publishers
2017-01-01
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| Series: | Case Reports in Ophthalmology |
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| Online Access: | http://www.karger.com/Article/FullText/456536 |
| _version_ | 1811241126303105024 |
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| author | Anmar M. Abdul-Rahman Anthony Molteno |
| author_facet | Anmar M. Abdul-Rahman Anthony Molteno |
| author_sort | Anmar M. Abdul-Rahman |
| collection | DOAJ |
| description | Purpose: To report a case of inadvertent bleb formation presenting 18 months after pars plana M3 Molteno implant tube obstruction in a patient with mixed mechanism glaucoma. Materials and Methods: An 84-year-old Caucasian male with mixed mechanism glaucoma underwent slit-lamp examination, gonioscopy, colour anterior segment photography and anterior segment optical coherence tomography (AS-OCT). Results: An inadvertent bleb developed 18 months after pars plana implant tube re-positioning with a 6/0 Vicryl tie ligature. The bleb was located in the area anterior to the implant plate; it was characterised by a thin, transparent, avascular and multi-cystic wall, with a visible stoma at the posterior edge of the bleb. The bleb was functioning as demonstrated by an intraocular pressure of 6 mm Hg at presentation and a punctate fluorescein uptake pattern of the bleb wall. The bleb over the plate of the Molteno implant was non-functioning, likely secondary to tube obstruction by vitreous in the early postoperative period. AS-OCT showed a tract from the anterior chamber commencing at an entry wound through a corneal tunnel to the posterior stoma at the base of the inadvertent bleb. Conclusions: We hypothesise that the pathophysiologic factors resulting in an inadvertent bleb are a result of a combination of apoptosis, late-onset wound dehiscence and internal gaping of a centrally placed corneal wound. In addition, aqueous hydrodynamic factors may play a role. |
| first_indexed | 2024-04-12T13:31:51Z |
| format | Article |
| id | doaj.art-3cab91fdb8ba44e6af27be94b487ffff |
| institution | Directory Open Access Journal |
| issn | 1663-2699 |
| language | English |
| last_indexed | 2024-04-12T13:31:51Z |
| publishDate | 2017-01-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Ophthalmology |
| spelling | doaj.art-3cab91fdb8ba44e6af27be94b487ffff2022-12-22T03:31:09ZengKarger PublishersCase Reports in Ophthalmology1663-26992017-01-0181738010.1159/000456536456536Late-Onset Inadvertent Bleb Formation following Pars Plana M3 Molteno Implant Tube ObstructionAnmar M. Abdul-RahmanAnthony MoltenoPurpose: To report a case of inadvertent bleb formation presenting 18 months after pars plana M3 Molteno implant tube obstruction in a patient with mixed mechanism glaucoma. Materials and Methods: An 84-year-old Caucasian male with mixed mechanism glaucoma underwent slit-lamp examination, gonioscopy, colour anterior segment photography and anterior segment optical coherence tomography (AS-OCT). Results: An inadvertent bleb developed 18 months after pars plana implant tube re-positioning with a 6/0 Vicryl tie ligature. The bleb was located in the area anterior to the implant plate; it was characterised by a thin, transparent, avascular and multi-cystic wall, with a visible stoma at the posterior edge of the bleb. The bleb was functioning as demonstrated by an intraocular pressure of 6 mm Hg at presentation and a punctate fluorescein uptake pattern of the bleb wall. The bleb over the plate of the Molteno implant was non-functioning, likely secondary to tube obstruction by vitreous in the early postoperative period. AS-OCT showed a tract from the anterior chamber commencing at an entry wound through a corneal tunnel to the posterior stoma at the base of the inadvertent bleb. Conclusions: We hypothesise that the pathophysiologic factors resulting in an inadvertent bleb are a result of a combination of apoptosis, late-onset wound dehiscence and internal gaping of a centrally placed corneal wound. In addition, aqueous hydrodynamic factors may play a role.http://www.karger.com/Article/FullText/456536Inadvertent blebGlaucomaOptical coherence tomographyMolteno implant |
| spellingShingle | Anmar M. Abdul-Rahman Anthony Molteno Late-Onset Inadvertent Bleb Formation following Pars Plana M3 Molteno Implant Tube Obstruction Case Reports in Ophthalmology Inadvertent bleb Glaucoma Optical coherence tomography Molteno implant |
| title | Late-Onset Inadvertent Bleb Formation following Pars Plana M3 Molteno Implant Tube Obstruction |
| title_full | Late-Onset Inadvertent Bleb Formation following Pars Plana M3 Molteno Implant Tube Obstruction |
| title_fullStr | Late-Onset Inadvertent Bleb Formation following Pars Plana M3 Molteno Implant Tube Obstruction |
| title_full_unstemmed | Late-Onset Inadvertent Bleb Formation following Pars Plana M3 Molteno Implant Tube Obstruction |
| title_short | Late-Onset Inadvertent Bleb Formation following Pars Plana M3 Molteno Implant Tube Obstruction |
| title_sort | late onset inadvertent bleb formation following pars plana m3 molteno implant tube obstruction |
| topic | Inadvertent bleb Glaucoma Optical coherence tomography Molteno implant |
| url | http://www.karger.com/Article/FullText/456536 |
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