DR. PRIYANKA SHYAM

, Dr. DEVENDRA MAHESHWARI, Dr. RAMAKRISHNAN

Abstract

Trabeculectomy, a mainstay in management of glaucoma is associated with complications like hypotony.Early hypotony occurs secondary to bleb leak.Late hypotony occur secondary to ischemic,avascular,thin overfiltering bleb.We present a challenging case of late-onset refractory hypotony following trabecuectomy.

A 64 year old male patient diagnosed as POAG in RE underwent Phacotriple.Three weeks later he presented with hypotony which responded well with medical management and was lost for follow-up.Two years later he presented with severe hypotony with shallow CDs in RE which failed to respond to medical management.Hence Compression sutures were placed over the bleb which also failed to respond.As he began to develop corneal decompensation,bleb repair was done with corneal patch graft which responded well with an improvement in visual acuity and IOP.This case report highlights the importance of prompt and timely intervention of an overfiltering bleb in preventing irreversible visual loss.