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We present a case of post-trabeculectomy encapsulated dysesthetic bleb with scleral fistula, managed successfully with autograft. The child was operated on twice before for trabeculectomy, and intraocular pressure (IOP) recorded was in the normal range for the initial few years. This time child presented with a large encapsulated dysesthetic bleb with borderline IOP. As the IOP was on the lower side, an underlyings cleral fistula was suspected and planned for bleb revision with a donor patch graft. We describe the novel technique of bleb revision along with the repair of the scleral fistula with an autologous free fibrotic Tenon's tissue graft instead of a donor patch graft with a successful outcome.
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http://dx.doi.org/10.4103/IJO.IJO_2946_22 | DOI Listing |
Eur J Ophthalmol
September 2025
Ophthalmology Department, Cliniques Universitaires Saint-Luc, Woluwé-Saint-Lambert, 10, Avenue Hippocrate, 1200 Brussels, Belgium.
Increased intraocular pressure due to elevated episcleral venous pressure is a recognized complication associated with arteriovenous fistulas, which typically form between the carotid artery and the cavernous sinus. We report a case of a patient who developed paradoxical worsening syndrome a few days after he underwent a two-staged transarterial embolization procedure of a left sided ethmoidal arteriovenous fistula. The patient presented with signs of elevated episcleral venous pressure leading to intraocular hypertension caused by the iatrogenic partial obstruction of the left superior ophthalmic vein.
View Article and Find Full Text PDFJ Curr Glaucoma Pract
January 2025
Department of Ophthalmology, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States.
Background: This article contains two cases with accompanying surgical videos, illustrating the use of a Tutoplast plug to create a watertight seal in the corneoscleral fistula formed after tube shunt removal.
Case Description: These cases demonstrate that Tutoplast can be cut into a strategic geometric shape to both plug the fistula formed at the tube entry site and reinforce adjacent areas of scleral thinning during tube removal or repositioning surgery. Specifically, a piece of dehydrated scleral Tutoplast was shaped into a small rectangle with an attached larger rectangle.
Ann Med Surg (Lond)
December 2024
Department of Neurosurgery, Neurosurgery Clinic, Birgunj, Nepal.
Introduction And Importance: A carotid-cavernous sinus fistula is an abnormal connection between the internal or external carotid artery and the venous system of the cavernous sinus. It represents a rare entity, and it is often misdiagnosed due to its overlapping symptoms with other conditions such as cavernous sinus thrombosis or orbital inflammation. Cerebral angiography continues to be the gold standard for diagnosis and surgical planning in patients with CCF, and the endovascular trans-venous approach still represents the primary line of treatment.
View Article and Find Full Text PDFEur J Paediatr Dent
September 2024
Director of the Postgraduate School of Paediatric Dentistry, University of Pisa.