Delayed suprachoroidal hemorrhage after needle revision of trabeculectomy bleb in a patient with hairy cell leukemia.

PURPOSE: To report a rare complication, delayed suprachoroidal hemorrhage, of needle revision of a nonfunctioning trabeculectomy bleb in a patient with previously undetected hairy cell leukemia. DESIGN: Interventional case report. METHODS; An 89-year-old man presented with massive delayed suprachoroidal hemorrhage after needle revision of a trabeculectomy bleb. RESULTS: Routine investigations before choriodal drainage showed a low platelet count. Anterior chamber washout and choroidal drainage were done after intravenous platelet infusions. Subsequently, the diagnosis of hairy cell leukemia was made by the hematologist. CONCLUSIONS: Delayed suprachoroidal hemorrhage is a rare but devastating complication of needle revision of trabeculectomy blebs and should be borne in mind while performing this seemingly trivial outpatient procedure.

Inferior conjunctival autograft for primary pterygia.

OBJECTIVE: Superior conjunctival graft is commonly used in pterygium surgery, which may adversely affect the outcome of future filtration surgery. We retrospectively studied the success rate of inferior conjunctival autografting for primary pterygia in our unit. DESIGN: A noncomparative, retrospective, interventional case series. PARTICIPANTS: Thirty eyes of 27 patients treated between August 1996 and February 2001 with primary pterygia. INTERVENTION: Excision of pterygium followed by conjunctival autograft harvested from the inferior bulbar conjunctiva. Surgeries were performed by an experienced surgeon (CL) in 23 patients and by trainees in the remaining four cases. MAIN OUTCOME MEASURES: Recurrence of the pterygium and complications. RESULTS: Mean follow-up was 27 months (range, 8-53). Recurrence occurred in one eye (3.3%). This was a white female in her early fifties, with recurrence detected 3 months after the surgery. Conjunctival scarring at the donor site was observed in 11 eyes (36.66%). There was no symblepharon formation. There was no restriction of up gaze. Hemorrhage under the conjunctival graft developed in three eyes, corneal dellen near the limbus developed in four eyes, and epithelial inclusion cysts at the recipient site developed in two eyes. CONCLUSIONS: Inferior conjunctival autografting is an effective technique with a low recurrence rate. This is a useful technique in cases in which it is not possible or desirable to use the superior conjunctiva as a donor source.