A bronchial obstruction of the remaining lung is a rare complication of thoracic surgery. We report a case of this rare complication after a right upper lobectomy due to a giant bulla. Post-resectional angulation of the bronchus intermedius caused the bronchial obstruction. An intrabronchial stent was inserted into the bronchus intermedius, which relieved the obstruction.
Blister ; Bronchi ; Lung ; Stents ; Thoracic Surgery

An overhanging, large bleb after filtering surgery leads to various complications ranging from foreign-body sensation to endophthalmitis. Herein we report two case of large painful blebs in nasal area. Argon laser was initially used for its shrinkage. However, this procedure was not successful, requiring surgical excision of bleb. The tissue was then examined to evaluate the cause of failure with the argon laser treatment. On examination, the bleb showed a pseudocyst, and hyaline degeneration in the inner membrane of the bleb. Shrinkage of the large bleb resulted in resolution of the pain.
Argon ; Blister* ; Endophthalmitis ; Filtering Surgery* ; Glaucoma* ; Hyalin ; Membranes ; Sensation

Endophthalmitis following the filtering surgery is rare and the visual prognosis is reported to be very poor. In many cases the infection starts in the bleb. Methods of treatment should be chosen according to the type and stage of infection, but the prompt use of appropriate antibiotic and corticosteroid is important. This report presents a case of endophthalmitis following trabeculectomy in a 61-year old female patient, which was successfully treated.
Blister ; Endophthalmitis* ; Female ; Filtering Surgery ; Humans ; Middle Aged ; Prognosis ; Trabeculectomy*

In glaucoma filtering surgery, we conducted subconjunctival injection of Mitomycin-C(MMC) 12 hours before and after surgery, and examined histologic findings of the filtering bleb, and condition of the anterior chamber which ensued after the injection. We divided 15 full-grown rabbits into three groups, and for each group, administered subconjunctivally 0.1cc of 0.002%, 0.004%, and 0.008% MMC, respectively. The subconjunctival injection of MMC before surgery was given to the right eye and post-surgical injection to the left, and we examined the results 1, 2, 4, 7, and 14 days after the administration.In conclusion, subconjunctival injection of MMC 12 hours before glaucoma filtering surgery is shown to be more effective than the injection after the surgery.
Anterior Chamber ; Blister* ; Filtering Surgery* ; Glaucoma* ; Mitomycin* ; Rabbits

PURPOSE: To investigate the effects of varying the time of Mitomycin-C (MMC) subconjunctival injection before, during and after operation. METHOD: We divided rabbits into 3 groups according to injection time. Subconjunctival injections of 0.01% MMC 0.05 ml were given to the preoperative group at 6, 12 and 24 hours before operation, and to the postoperative group at 6, 12 and 24 hours after operation. The control group was given the injections during operation. Bleb formation and histologic analyses were studied for 4 weeks after operation. RESULTS For gross findings, the blebs of the preoperative and control groups were seen on the fourth day and completely formed at one week after operation, and were larger than those of the postoperative group. On the other hand, the blebs of the postoperative group were seen to have poor formation, displaying hypervascularity on the fourth day and disappearing one week after operation. For histologic findings, the proliferation of collagen fibers and the undifferentiation of fibroblasts observed in the preoperative and control groups were almost identical. But, the proliferation of collagen fibers and well-differentiated fibroblasts were seen to increase in the postoperative group, so aqueous flow was obstructed at week 3. CONCLUSIONS: Subconjunctival injections within 24 hours before or during glaucoma filtration surgery were better for bleb formation and preservation than those administerd after surgery.
Blister ; Collagen ; Fibroblasts ; Filtering Surgery* ; Filtration* ; Glaucoma* ; Hand ; Mitomycin* ; Rabbits*

PURPOSE: To investigate the effects of varying the time of Mitomycin-C (MMC) subconjunctival injection before, during and after operation. METHOD: We divided rabbits into 3 groups according to injection time. Subconjunctival injections of 0.01% MMC 0.05 ml were given to the preoperative group at 6, 12 and 24 hours before operation, and to the postoperative group at 6, 12 and 24 hours after operation. The control group was given the injections during operation. Bleb formation and histologic analyses were studied for 4 weeks after operation. RESULTS For gross findings, the blebs of the preoperative and control groups were seen on the fourth day and completely formed at one week after operation, and were larger than those of the postoperative group. On the other hand, the blebs of the postoperative group were seen to have poor formation, displaying hypervascularity on the fourth day and disappearing one week after operation. For histologic findings, the proliferation of collagen fibers and the undifferentiation of fibroblasts observed in the preoperative and control groups were almost identical. But, the proliferation of collagen fibers and well-differentiated fibroblasts were seen to increase in the postoperative group, so aqueous flow was obstructed at week 3. CONCLUSIONS: Subconjunctival injections within 24 hours before or during glaucoma filtration surgery were better for bleb formation and preservation than those administerd after surgery.
Blister ; Collagen ; Fibroblasts ; Filtering Surgery* ; Filtration* ; Glaucoma* ; Hand ; Mitomycin* ; Rabbits*

Endophthalmitis is a severe and unfortunate complication after glaucoma filtering surgery which may present months to years after the initial surgical intervention. Amniotic membrane is immunologically inert and has antiadhesive and wound-protectioning effects. Furthermore, it reduces pain and helps epithelization. So several reports disclosed the uses of amniotic membrane in transplantation for reconstruction of various ocular surface diseases recently. We report the usefulness of antibiotics-soaked amniotic membrane transplatation for endophthalmitis with bleb rupture 4 years after trabeculectomy.
Amnion* ; Blister ; Endophthalmitis* ; Filtering Surgery ; Glaucoma ; Rupture ; Trabeculectomy

PURPOSE: We investigated the anti-inflammatory and anti-fibrotic effects of amniotic membrane(AM) ointment in filtering surgery of rabbits. METHODS: After filtering surgery was performed on both eyes of 10 rabbits, the AM ointment was applied over and under the scleral flap on one eye whereas base ointment excluding AM element was applied to the other as a control. The shapes of blebs were observed under slit-lamp biomicroscopy at postoperative 3 days, 1 week, 2 weeks and 4 weeks, and the tissues were excised for histologic studies. RESULTS: Serial changes of intraocular pressures had no significant difference. Slit-lamp biomicroscopy demonstrated that conjunctival blebs of AM ointment group were more elevated and cystic at 1 and 2 weeks. The heights of conjunctival blebs were significantly higher at 1, 2 and 4 weeks, and the width of scleral tracks was significantly wider at 1 and 2 weeks in AM ointment group. The number of inflammatory cells in the scleral track was significantly less at 3 days and 1 week, the number of fibroblasts in scleral track was significantly less at 2 and 3 weeks in AM ointment group. Masson s trichrome stain was less positive in AM ointment and the stain area of alpha-smooth muscle actin-positive fibroblasts was insignificant with image analysis system. Collagen type 3 appeared in scleral track from postoperative 1 week in control group, however, in AM ointment group, from 4 weeks. CONCLUSIONS: AM ointment is beneficial to suppress fibroblast differentiation, proliferation and inflam-matory reaction in filtering surgery and might be safe and effective adjunctive for enhancement of success in filtering surgery.
Amnion* ; Blister ; Collagen ; Fibroblasts ; Filtering Surgery* ; Humans* ; Intraocular Pressure ; Rabbits*

We examined the differences of the glaucoma filtering blebs according to the application methods of mitomycin C (subconjunctival injection and soaking). We performed filtering surgery from the anterior chamber to the subconjunctival space with the silicone tube, in both eyes of 12 grey rabbits. In one eye, subconjunctival injection of the mitomycin-C 0.05ml after filtering surgery (concentration 0.004, 0.008, 0.012, 0.016%) was performed and on the other eye, Weck-Cel sponge soaked with the 0.04% mitomycin-C was applied for 3 minutes and the wound was washed with copious amount of balanced salt solution before the closure of wound. We examined the size, shape, vascular distribution of the filtering blebs and status of the anterior chamber after filtering surgery. We obtained the tissues of the filtering bleb at 7days, 14days and 21days after surgery and microscopic examinations were performed. In subconjunctival injection with the 0.004% of mitomycin-C, bleb size and its duration was small and short than those eyes with the soaking. In eyes with subconjunctival injection with the 0.008% of mitomycin-C, bleb size and its duration showed similiar blebs to soaking cases and anterior chamber was shallow in one eye. In case of 0.012% subconjunctival injection, bleb size and duration were greater than those with soaking and slightly shallow anterior chamber was shown in all cases. In cases of subconjunctival injection with 0.016% mitomycin-C, shallow anterior chamber and hypotony were common. In histological examination, there was similiar findings of fibroblast activity between 0.008% subconjunctival injection and 0.004% soaking cases. Therefore we conclude that the concentration of mitomycin-c in subconjunctival injection for glaucoma filtering surgery should not be higher than 0.008%.
Anterior Chamber ; Blister ; Fibroblasts ; Filtering Surgery ; Glaucoma ; Mitomycin* ; Porifera ; Rabbits ; Silicones ; Wounds and Injuries

An antimetabolite, 5-fluorouracil(5-FU) has a property of inhibiting fibroblast proliferahon and is known to increase success rate of glaucoma filtering surgery in patients at risk by preventing postoperative scarring of a filtering bleb. Thirteen eyes of 13 patients with uncontrolled glaucoma at high risk for failures of standard filteration underwent trabeculectomy with post-operative 5-FU subconjunctival injections. The mean follow-up time was 7.3 months. The intraocular pressure was controlled in 77% of the over-all study patients after 1 month, 69% after 2 months and 54% after 6months, respectively. In patients with neovascular glaucoma, the intraocular pressure was controlled in 80% of the patients after 1 month and 60% after 2 months and 40% after 6 months. A corneal epithelial defect was the most common complicatio. No other severe complications were observed.
Blister ; Cicatrix ; Fibroblasts ; Filtering Surgery* ; Fluorouracil ; Follow-Up Studies ; Glaucoma ; Glaucoma, Neovascular ; Humans ; Intraocular Pressure ; Trabeculectomy