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First Author: J.Nemes HUNGARY
Co Author(s): A. Makay
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To present two late choroidal detachment cases and their management 10 and 8 years after trabeculectomy
Ophthalmology Department, Ferenc Flor Pest County Hospital, Kistarcsa, Hungary
Case one: 80 year old woman with open angle glaucoma developed low intra ocular pressure (IOP), visual loss and almost kissing choroidal detachment 10 years after previous trabeculectomy and 11 years after cataract operation on her right eye. Case two: 89 year old man with open angle glaucoma 8 years after trabeculectomy had uneventful phacoemusification and foldable posterior chamber lens implantation on his left eye. In the early postoperative period low IOP and choroidal detachment developed. In both cases microperforation of the filtering bleb were noted.
In case one after unsuccessful suturing of microperforation the scarred filtration bleb was covered with conjunctival autograft. In case two the microperforation was sutured. After both operations IOP increased to normal range, choroid attached and visual acuity developed from light perception to 0,3 in case one and from 0,02 to 0,25 in case two.
Choroidal detachment is a vision threatening condition and subtle opening of the scarred filtration bleb may cause a diagnostic and therapeutic problem several years after trabeculectomy. Direct or indirect closing of the microperforation is essential to reach choroidal attachment and normal IOP.