BLEB RUPTURE FOLLOWING FILTERING SURGERY WITH MITOMYCIN-C - CLINICOPATHOLOGICAL CORRELATIONS

A 91-year-old woman with a complete rupture of her mitomycin-C filtrat ion bleb associated with eye rubbing while crying was examined. An 18- mm soft contact lens was placed preoperatively to reform the anterior chamber and the patient underwent a conjunctival advancement, Histopat hology of the free conjunctival specimen revealed a stratified squamou s epithelium with marked attentuation of the subepithelial tissue in t he area treated with mitomycin-C, Bleb rupture may be associated with minimal physical trauma following guarded filtration surgery. Successf ul visual rehabilitation is possible with conjunctival advancement, ye t long-term survival of-the bleb is poor. [Ophthalmic Surg Lasers 1996 ; 27:876-877]. Mitomycin-C is a bifunctional alkylating agent that has significantly improved the success rare of glaucoma filtering surgery in patients at high risk for surgical failure.(1) There has been a co ncomitantly higher rate of postoperative complications associated with its use, such as ocular hypotony.(2) Whereas conjunctival hypocellula rity and collagen disorganization have been demonstrated following the intraoperative application of mitomycin-C,(3) to the best of our know ledge no reports have described frank bleb rupture following the use o f mitomycin-C, We treated a patient who had disintegration of her conj unctival filtering bleb associated with minimal physical trauma.