Bleb Leak With Hypotony After Laser Suture Lysis and Trabeculectomy With Mitomycin C

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Abstract
We describe two cases of persistent bleb leak with hypotony after argon laser suture lysis (ALSL). One case occurred 16 days after trabeculectomy using intraoperative mitomycin C, and the other, 16 weeks after trabeculectomy. We wish to alert other practitioners to the slowed healing of conjunctiva after trabeculectomy involving mitomycin C.1-3 In each patient, a cellulose sponge soaked in a 0.5-mg/mL solution of mitomycin C was placed between the episclera and the conjunctiva for 4 minutes after the trabeculectomy flap had been outlined, but before it had been dissected. See also pp 1069, 1072, and 1150. Report of Cases.—Case 1. —A 60-year-old man had sustained blunt trauma with displacement of the superior haptic of the posterior chamber intraocular lens, angle recession, and sustained elevation of intraocular pressure that was unresponsive to maximum medical therapy. Three weeks after the injury, he underwent trabeculectomy with repositioning of the lens