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KMID : 0360220180590090887
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Journal of the Korean Ophthalmological Society
2018 Volume.59 No. 9 p.887 ~ p.892
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Conjunctival Necrosis following Ahmed Valve Implantation and Subtenon Triamcinolone Injection
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Park Kee-Sup
Kim Kyoung-Nam
Kim Woo-Jin
Lee Sung-Bok
Kim Chang-Sik
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Abstract
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Purpose: We report a case of conjunctival necrosis in a glaucoma patient who underwent Ahmed valve implantation and subtenon triamcinolone injection.
Case summary: A 22-year-old female was referred to our clinic for uncontrolled intraocular pressure despite trabeculectomy and repeated 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.
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KEYWORD
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Ahmed valve, Conjunctival necrosis, Glaucoma, Mitomycin C, Triamcinolone
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