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Editors Selection IGR 21-4
Surgery: Treatment of hypotony
Comment by Esther Hoffmann on:
22346 Efficacy and safety of transconjunctival scleral flap resuturing for hypotony after glaucoma filtering surgery, Maruyama K; Shirato S, Graefe's Archive for Clinical and Experimental Ophthalmology, 2008; 246: 1751-1756
The retrospective study by Maruyama and Shirato (1759) evaluates the efficacy and safety of transconjunctival flap suturing for hypotony after filtering glaucoma surgery. Fifty-six eyes were included and underwent flap suture using a 10.0 nylon suture with a round tapered needle. Hypotony was defined as an IOP below 6 mmHg leading to hypotony maculopathy or choroidal detachment. In 92%, hypotony maculopathy was resolved after suture resulting in improved visual acuity.
Transconjunctival flap suturing is a simple surgical technique to treat hypotony maculopathyNo bleb infection occurred. The technique described is an effective and minimally invasive procedure to treat hypotony maculopathy. This study is, therefore, in agreement with an earlier prospective study carried out by Eha and colleagues (Eha J, Hoffmann EM, Wahl J, Pfeiffer N. Flap suture ‐ a simple technique for the revision of hypotony maculopathy following trabeculectomy with mitomycin C. Graefes Arch Clin Exp Ophthalmol 2008, 246: 869-874). Despite its retrospective design, the paper is very interesting and important since it highlights a simple surgical technique to treat hypotony maculopathy after glaucoma surgery that is safe and effective and avoids the re-opening of the conjunctiva.
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