Bleb rupture following filtering surgery with mitomycin-C: Clinicopathologic correlations

A 91-year-old woman with a complete rupture of her mitomycin-C filtration 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, Histopathology of the free conjunctival specimen revealed a stratified squamous epithelium with marked attentuation of the subepithelial tissue in the area treated with mitomycin-C, Bleb rupture may be associated with minimal physical trauma following guarded filtration surgery. Successful visual rehabilitation is possible with conjunctival advancement, yet 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 concomitantly higher rate of postoperative complications associated with its use, such as ocular hypotony.(2) Whereas conjunctival hypocellularity and collagen disorganization have been demonstrated following the intraoperative application of mitomycin-C,(3) to the best of our knowledge no reports have described frank bleb rupture following the use of mitomycin-C, We treated a patient who had disintegration of her conjunctival filtering bleb associated with minimal physical trauma.