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Trabeculectomy, MMC and bullous keratopathy link established

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Bullous keratopathy is a potential complication of trabeculectomy with mitomycin C, according to a small case series.

Holger Mietz and colleagues at the Aschaffenburg Eye Center described the cases of two patients who underwent routine trabeculectomy with mitomycin C (MMC). In these two cases, partial decomposition of the corneal endothelium resulted in a well-demarcated clear zone of the cornea and a second zone with thickening of the cornea and a bullous keratopathy adjacent to the filtering bleb.

Marked irregularities of the endothelial cells and areas of necrosis in those parts of the cornea close to the filtering bleb were seen on specular microscopy.

“The application of MMC may have an additional toxic effect on the endothelium and may result in a partial bullous keratoplasty,” they said.

The study is published in Graefe’s Archive for Clinical and Experimental Ophthalmology.