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Scleral punch method with topical mitomycin c for safe revision of failed deep sclerectomy in nanophthalmic uveal effusion syndrome

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Abstract

Purpose

To describe a novel surgical technique for revision of deep sclerectomy surgery in nanophthalmic uveal effusion syndrome.

Methods

A 46-year-old woman with recessively inherited nanophthalmos and chronic uveal effusions underwent a revision of previous failed deep sclerectomy surgery. In the presence of scar tissue, revision of sclerectomies was greatly facilitated by the use of a Kelly scleral punch (Katena Products, Inc., Denville, NJ, USA). To inhibit further scarring, mitomycin-C (MMC) was applied topically in each quadrant posterior to the equator.

Results

The scleral punch allowed outward scleral dissection from the suprachoroidal space, and brisk enlargement of sclerectomies in all quadrants without perforation of choroidal tissue. Post-operative conjunctival wound healing appeared unimpeded by the posteriorly placed MMC sponges. Near-total resolution of the effusions had occurred by 3 months.

Conclusions

The scleral punch provides a safe and effective method for constructing and revising full-thickness sclerectomies in the nanophthalmic eye, minimizing the risk of choroidal trauma. The use of topical MMC may reduce the risk of late failure of trans-scleral outflow due to fibrosis.

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Funding

The Health Foundation and the UCL-Moorfields NIHR Biomedical Research Centre.

Financial Disclosures

None.

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Authors and Affiliations

  1. Vitreoretinal Service, Moorfields Eye Hospital, City Road, London, EC1V 2PD, UK

    Nelson A. Sabrosa, Henry B. Smith & Robert E. MacLaren

  2. UCL Institute of Ophthalmology, London, EC1V 9EL, UK

    Robert E. MacLaren

Authors
  1. Nelson A. Sabrosa
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  2. Henry B. Smith
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  3. Robert E. MacLaren
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Corresponding author

Correspondence to Nelson A. Sabrosa.

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Sabrosa, N.A., Smith, H.B. & MacLaren, R.E. Scleral punch method with topical mitomycin c for safe revision of failed deep sclerectomy in nanophthalmic uveal effusion syndrome. Graefes Arch Clin Exp Ophthalmol 247, 999–1001 (2009). https://doi.org/10.1007/s00417-008-1020-3

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  • DOI: https://doi.org/10.1007/s00417-008-1020-3

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