Abstract

Study design: Case report
Case description: A 68 year old lady with bilateral advanced glaucoma with CDR 0.9:1 on MMT and immature cataract was planned for sequential combined Phacoemulsification and Trabeculectomy with Mitomycin C. After uneventful surgery OU, patient had BCVA of 6/6 OU with well controlled IOP in the range of 12-14 mm Hg but right eye developed very high nasal bleb with E3V2H3. She was initially managed conservatively with torpedo bandage and early tapering of steroids. But the bleb dysaesthesia increased over a period of time and the patient became fairly symptomatic with excessive watering and difficulty in opening of right eye. The giant bleb measured approx. 5×12 mm and patient was posted for bleb repair with amniotic membrane grafting. BCL was applied for symptomatic relief. HPE revealed pemphigoid dermatosis. At 3 mo post operatively, patient is asymptomatic with BCVA 6/6, fully functional bleb with E2V1H2 and IOP in the range of 14-16 mm Hg on no AGM.