J Korean Ophthalmol Soc > Volume 51(9); 2010 > Article
Journal of the Korean Ophthalmological Society 2010;51(9):1287-1291.
DOI: https://doi.org/10.3341/jkos.2010.51.9.1287    Published online September 15, 2010.
A Case of Corneal Endothelial Damage by 5-Fluorouracil Inflow Into Anterior Chamber After Subconjunctival Injection.
Dae Hee Kim, Min Ho Kim, Jae Hong Ahn
Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea. chrisahn@ajou.ac.kr
결막하 5-Fluorouracil 주입술 후 전방 내 유입에 의한 각막 내피세포 손상 1예
김대희ㆍ김민호ㆍ안재홍
Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea
Abstract
PURPOSE
To present a case of corneal endothelial damage caused by inflow of 5-FU after subconjunctival 5-FU injection in a patient undergoing trabeculectomy. CASE SUMMARY: A 65-year-old female patient diagnosed with chronic angle-closure glaucoma underwent trabeculectomy using mitomycin C. Three weeks after the surgery, her intraocular pressure (IOP) elevated, and the follicles had disappeared by trabeculectomy. Subsequently, subconjunctival 5-FU injection was performed. Following the fourth injection, visual acuity abruptly decreased, and corneal edema was observed. Upon presumption of inflow of 5-FU into the anterior chamber, anterior chamber irrigation was performed within 40 minutes. On postoperative day 1, visual acuity decreased from 0.8 to counting fingers, and diffuse corneal edema and anterior capsular opacity of the lens were noted. Three months after the irrigation, visual acuity improved to 0.8. Corneal edema and capsular opacity also improved, however the density of the corneal endothelial count decreased. CONCLUSIONS: Inflow of 5-FU into the anterior chamber can cause corneal and lenticular toxicity. Anterior chamber irrigation is considered necessary to prevent 5-FU toxicity.
Key Words: Corneal endothelium;Needling;Subconjunctival injection;Trabeculectomy;5-Fluorouracil (5-FU)


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