Severe Hypotony After Glaucoma Filtering Surgery

To develop a surgical tactic based on the results of treating severe hypotony after anti-glaucoma surgery

IRTC "Eye Microsurgery", Ekaterinburg Center

Methods: A total of 62 eyes of 59 patients (37 females, 25 males) aged between 13 and 85 years (mean age 552) were analyzed. All patients had severe hypotony after various types of anti-glaucoma procedures including trabeculectomy (n=7), revision of anti-glaucoma surgery zone (n=4), transciliary draining of posterior chamber (n=1), and nonpenetrating deep sclerectomy (n=50, among which 46
followed goniopuncture). Antimetabolites were used in 35 cases.

Surgical techniques included: external fistula plombage using a fragment of Tenon's capsule (n=23), internal fistula plombage using a fragment of Tenon's capsule (n=16), and internal fistula plombage using a fragment of Tenon's capsule via tunnel technique (n=23)

Results: One year after surgery, mean visual acuity improved from 0.35+/-0.17 to 0.7+/-0.16, while intraocular pressure rose from 4.8+/-2.3 to 13.4+/-2.3 mm Hg. No signs of maculopathy were observed in
any patient during the follow-up period.

Conclusions: The proposed surgical strategies demonstrated effectiveness and are recommended for
broad implementation in clinical ophthalmologic practice.