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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.

Original publication

DOI

10.1007/s00417-008-1020-3

Type

Journal article

Journal

Graefes Arch Clin Exp Ophthalmol

Publication Date

07/2009

Volume

247

Pages

999 - 1001

Keywords

Administration, Topical, Body Fluids, Cicatrix, Female, Humans, Microphthalmos, Middle Aged, Mitomycin, Nucleic Acid Synthesis Inhibitors, Ophthalmologic Surgical Procedures, Reoperation, Sclera, Syndrome, Uveal Diseases, Wound Healing