Spontaneous Dislocation of Trabeculectomy Scleral Flap in the Anterior Chamber in a Patient With Pseudoxanthoma Elasticum.

We report a case of a 54-year-old man, known to have pseudoxanthoma elasticum (PXE), who had a trabeculectomy in his left eye for secondary glaucoma following blunt trauma. Ten years after augmented trabeculectomy, the patient presented to casualty clinic with an inferiorly dislocated, anterior chamber (AC), scleral trabeculectomy flap. Corrected vision was hand movement with an intraocular pressure of 17 mm Hg. There was significant AC inflammation (cells 2+). Gonioscopy revealed a residual mobile scleral flap. The bleb was cystic with no leak. To our knowledge this is the first report of a trabeculectomy scleral flap dislocation into the AC in a patient with PXE. Ophthalmologists should be aware of this complication in patients with PXE.