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Abstract #9045 Published in IGR 5-2
Management of hypotony following glaucoma filtration surgery
Moutz Leen M; Smit BComprehensive Ophthalmology Update 2003; 4: 109-120
Hypotony following glaucoma filtration surgery is expected to occur more frequently as the use of antimetabolites increases, sometimes occurring years after the initial surgery. Structural complications of hypotony include corneal irregularities/edema, inflammation, shallow anterior chamber, cataract, macular edema, hypotony maculopathy, and choroidal effusion. Each of these structural findings can be associated with functional complications, including reduced visual acuity and ocular discomfort. Early postoperative hypotony is frequently self-limited, and intervention is considered for high-risk findings, including persistent bleb leak, flat anterior chamber, kissing choroidal effusions, and cyclodialysis cleft. Appropriate interventions may include direct closure of a bleb leak, drainage of choroidal fluid, and closure of a cyclodialysis cleft. Nonincisional management techniques, including autologous blood injection, compression suture, and laser revision, have modest success rates. Recently, incisional bleb revision has been reported to demonstrate a more promising success rate, although often requiring the addition of antiglaucoma medications.
Dr. M. Moutz Leen, Pacific Eyecare, 2601 Cherry Avenue, Suite 215, Bremerton, WA 98310, USA. vhleen@aol.com
Classification:
12.8.11 Complications, endophthalmitis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
