J Korean Ophthalmol Soc.  2018 Sep;59(9):887-892. 10.3341/jkos.2018.59.9.887.

Conjunctival Necrosis following Ahmed Valve Implantation and Subtenon Triamcinolone Injection

• Park KS
• Kim KN
• Kim WJ
• Lee SB
• Kim CS

• KMID: 2420340
• DOI: http://doi.org/10.3341/jkos.2018.59.9.887

Abstract

PURPOSE
We report a case of conjunctival necrosis in a glaucoma patient who underwent Ahmed valve implantation and subtenon triamcinolone injection.
CASE SUMMARY
subconjunctival injections of mitomycin C in her right eye. Ahmed valve implantation and subtenon triamcinolone injection were performed in the right eye. Four weeks later, conjunctival necrosis was observed. After debridement of necrotic tissue, an additional conjunctival autograft was needed because of recurrence of the conjunctival necrosis. After amniotic membrane transplantation was performed for one more recurrent conjunctival necrosis, conjunctival epithelialization was completed.
CONCLUSIONS
Although conjunctival necrosis after periocular injection of triamcinolone is a rare complication, previous multiple usage of antimetabolites such as mitomycin C might be associated with a higher risk of developing conjunctival necrosis. In such cases, aggressive surgical intervention may be helpful in the reconstruction of the conjunctival epithelium.

Keyword

Ahmed valve; Conjunctival necrosis; Glaucoma; Mitomycin C; Triamcinolone

MeSH Terms

Amnion
Antimetabolites
Autografts
Debridement
Epithelium
Glaucoma
Humans
Injections, Intraocular
Mitomycin
Necrosis*
Recurrence
Triamcinolone*
Antimetabolites
Mitomycin
Triamcinolone