PMC4669919_01
Apparent point leakage with severe ocular surface failure.. Notes: (A) Anterior segment photograph taken using a fundus camera 2 days after trabeculectomy. (B) The fundus camera in the fluorescein angiogram mode can distinguish exciting light from emitted light and allows the examination of epithelial failure in high contrast by using the appropriate filters. Severe epithelial failure of the bleb wall and cornea is observed and a leakage point is visible (arrows).
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On examination, severe keratoconjunctival epithelial failure (Figure 1) was detected, and the patient was treated with 0.1% sodium hyaluronate eye drops (Hyalein; Santen Pharmaceutical Co Ltd, Osaka, Japan) administered six times daily with the patient lying supine to allow the drops to spread onto the upper blebs.
(A and B) Photographs obtained 2 days after the initiation of sodium hyaluronate eye drops.. Notes: The images show improvement of epithelial failure and resolution of the leakage point. Several microcysts are visible on the bleb surface at the sites where the epithelial failure showed improvement.
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With this treatment, improvement in the epithelial failure was seen at some sites, which showed the presence of many microcysts on the bleb surface; the leakage resolved completely 2 days after starting the sodium hyaluronate eye drops without using compression bandage (Figure 2).
(A and B) Photograph taken 1 month after initiation of treatment with sodium hyaluronate eye drops.. Note: The microcysts are absent and the bleb surface is smooth.
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One month after starting this treatment, the microcysts disappeared; the bleb surface was smooth; and the IOP was 10 mmHg (Figure 3).