Extensive Submacular Hemorrhage After Trabeculectomy With Mitomycin C

Purpose: We report the occurrence of an extensive submacular hemorrhage after trabeculectomy with mitomycin C in a patient with an occult choroidal neovascular membrane (CNVM). Patients and Methods: A 66-year-old man had a 3-year history of primary open-angle glaucoma in the left eye, which had been treated with topical antiglaucoma medication. The patient had age-related macular degeneration with an occult CNVM, for which he had received 5 intravitreal injections of ranibizumab and 5 intravitreal injections of bevacizumab in the left eye over a 3-year period. As intraocular pressure was not under control in the left eye over a 2-month period, trabeculectomy with mitomycin C was performed. Results: On the first postoperative day, intraocular pressure was 8 mm Hg with a well-formed bleb in the left eye. However, extensive subretinal hemorrhage was observed, and the patient underwent pneumatic displacement and pars plana vitrectomy to remove the hemorrhage. After 7 months, extensive subretinal fibrosis was observed and visual acuity was low (hand movement only). Conclusions: To our knowledge, this is the first report of an extensive submacular hemorrhage after trabeculectomy with mitomycin C in a patient with an occult CNVM.