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Abstract
Purpose
Recently, biodegradable collagen matrix has been used as a possible substitute for antimetabolite in trabeculectomy in order to control the responsiveness of the wound healing process. This paper reports a case of encapsulation of the biodegradable collagen matrix after trabeculectomy.
Case summary
We conducted a fornix-based trabeculectomy on a 58-year-old man with medically uncontrollable steroid-in-duced glaucoma. We implanted biodegradable collagen matrix onto the sclera flap beneath the conjunctiva. Immediately after the surgery, we observed a localized bleb with high elevation. In the three months of follow-up, the bleb became encapsulated, and an increase in intraocular pressure was noted. During the wound revision, encapsulated material surrounded by thick fibrous membrane was found and removed from the subconjunctival space, followed by biopsy. Biopsy results demonstrated that amorphous collagenous material was surrounded by spindle and inflammatory cells.
References
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Figure 1.
Dome-shaped, tense, opalescent, thick-walled encapsulated bleb is noted in the superior conjunctival area at postoperative 3 months. IOP ranged from 30 to 48 mm Hg during the 3-month follow-up period.
Figure 2.
Bleb revision procedure. (A) Conjunctiva is incised at the forniceal area. (B) Encapsulated tense opaque biomaterial is noted and dissected from the overlying conjunctiva. (C, D) Encapsulated material is dissected from the previous scleral flap. (E, F) Encapsulated material is removed from the subconjunctival space. (G, H) The conjunctiva is sutured.
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