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In this letter, the author discusses trabeculectomy for central retinal artery occlusion. The case is a 56-year-old man with a four-hour history of decreased vision in his right eye. This was due to a central retinal artery occlusion. Immediate paracentesis was performed. The pressure was reduced to 7 mmHg. Vision improved from reading fingers to 6/36. When the pressure had risen to 18 mmHg again, the vision started to deteriorate. A further paracentesis followed by acetazolamide improved the vision to 6/36. After paracentesis on each occasion his pupil response returned and his retinal circulation was restored. The authors decided to perform a trabeculectomy, which was performed approximately four hours after the first presentation. At pressures of around 18 mmHg, the visual acuity improved to 6/24. In fact the authors suggest that acute trabeculectomy may well have a use in patients in whom there is an improvement in vision with paracentesis.
12.8.1 Without tube implant (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
15 Miscellaneous