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Deregulation of the trabeculectomy bleb and loss of IOP control Following Nd: Yag capsulotomy

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Session Details

Session Title: Special Cases
Session Date/Time: Friday 26/02/2016 | 08:30-10:00
Paper Time: 09:06
Venue: MC3 Room
First Author: : P.Giannakouras GREECE
Co Author(s): :    A. Diagourtas   P. Giannakouras   K. Oikonomakis   A. Vergados   D. Papakonstantinou  

Abstract Details


To document the long term effect of Nd: Yag (Neodymium-doped:Yttrium Aluminium Garnet laser) capsulotomy on intraocular pressure (IOP) control and trabeculectomy bleb integrity, in a series of eyes, both trabeculectomised and pseudophakic, after the management of posterior capsular opacification (PCO).


Department of ophthalmology, Athens University Hospital (“G.Gennimatas”, Athens, Greece)


This is a retrospective non comparative case series. A number of eyes that had undergone standard uncomplicated trabeculectomy followed by uncomplicated phacoemulsification or extracapsular cataract extraction, previously with well functioning filtering blebs. Following the treatment with Nd: Yag capsulotomy for management of PCO were presented with uncontrolled IOP.


Twenty eyes of fifteen patients were included in the analysis. All patients showed flat filtering bleb and uncontrolled IOP (34.5 ± 11 mmHg), under maximum topical treatment, in a period of 2 to 6 months following Nd: YAG laser capsulotomy. The implantation of Ahmed valve proved to be effective treatment for these patients (IOP< 21mmHg).


Our study shows destabilization of a well-functioning bleb and the need for further surgical treatment in a considerable number of patients undergoing Nd:Yag capsulotomy. This is in contrast to reports from the literature concluding that capsulotomy does not significantly alter the bleb function (or the number of glaucoma medications used after the procedure), or that it can contribute to the loss of baseline IOP in up to 50% of cases. Further comparative studies are needed in order to confirm our findings.

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