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Purpose: We report a case of conjunctival necrosis in a glaucoma patient who underwent Ahmed valve implantation and subtenon triamcinolone injection. Case summary: A 22-year-old female was referred to our clinic for uncontrolled intraocular pressure despite trabeculectomy and repeated subconjunctival injections of mitomycin C in her right eye. Ahmed valve implantation and subtenon triamcinolone injection were performed in the right eye. Four weeks later, conjunctival necrosis was observed. After debridement of necrotic tissue, an additional conjunctival autograft was needed because of recurrence of the conjunctival necrosis. After amniotic membrane transplantation was performed for one more recurrent conjunctival necrosis, conjunctival epithelialization was completed. Conclusions: Although conjunctival necrosis after periocular injection of triamcinolone is a rare complication, previous multiple usage of antimetabolites such as mitomycin C might be associated with a higher risk of developing conjunctival necrosis. In such cases, aggressive surgical intervention may be helpful in the reconstruction of the conjunctival epithelium. J Korean Ophthalmol Soc 2018;59(9):887-892

Conjunctival Necrosis following Ahmed Valve Implantation and Subtenon Triamcinolone Injection