Extreme ocular hypotension treated with platelet-rich plasma (E-PRP)

Session Details

Session Title: Glaucoma & Posterior Segment

Session Date/Time: Monday 24/09/2018 | 08:00-10:30

Paper Time: 09:12

Venue: Room A3, Podium 1

First Author: : O.Al-Rahman SPAIN

Co Author(s): :    A. Rodriguez   J. Alio Del Barrio   J. Alio              

Abstract Details

Purpose:

To report a new surgical technique for the treatment of ocular hypotony by injecting autologous platelet-rich plasma in the anterior chamber.

Setting:

This new surgical technique was carried at Vissum Alicante.

Methods:

Platelet rich plasma (E-PRP) is used to enhance wound healing and stimulates tissue regeneration; this enhancing effect is attributed to essential growth factor and cell adhesion molecules and over 30 known biologically active substances such as fibroblast growth factor, vascular endothelial growth factor or epidermal growth factor. A 49 years old man diagnosed with Axenfield Rieger’s syndrome with lost left eye vision and right eye pseudophakic severe chronic hypotony reaching zero mmHg and severe corneal edema due to endothelial cell dysfunction following glaucoma surgery with mitomycin C was injected by 0.3 ml of E-PRP once in the anterior chamber.

Results:

Intraocular pressure (IOP) was measured by Goldman’s applanation tonometry 1st hr after intracameral injection of E-PRP, it was 30 mmHg then 6 hrs later it became 18mm Hg. During the follow-up periods of at least 6 months, IOP was controlled and remained stable. YAG laser was done to dissolve the remnants of clotted E-PRP in the anterior chamber. No filtration or hypotony were observed. Descemet membrane endothelial keratoplasty (DMEK) was then done to treat the severe corneal edema, the distant unaided visual acuity was improved from 0.05 before surgery to 0.7.

Conclusions:

E-PRP successfully ended the dilemma of positive filtration of the bleb post glaucoma surgery with mitomycin C and the progressive decrease of intraocular pressure. No intra or postoperative complications were observed. Intracameral platelet rich plasma (E-PRP) injection showed to be effective, rapid, and safe procedure in treating severe chronic hypotony following positive filtrating bleb in glaucoma surgery with mitomycin C.

Financial Disclosure:

-