Dr. DEVENDRA MAHESHWARI

DR. PRIYANKA SHYAM, DR. PRIYANKA SHYAM, Dr. RAMAKRISHNAN

Abstract

Hypotony secondary to overfiltration is a recognized complication following trabeculectomy augmented with antimetabolites. Persistent hypotony requires intervention and we describe a modified version of placing conjunctival compression sutures directly over the scleral flap.

A 70 year old male patient diagnosed as POAG in both eyes underwent combined surgery in RE . On the tenth post-operative day, patient presented with severe hypotony with 360˚CDs. He was treated with steroids and cycloplegics to which he responded shortly but developed hypotony maculopathy on subsequent follow-up. Hence he was managed surgically by trans-conjunctival flap sutures to which he responded dramatically with improvement in visual acuity,IOP and resolution of CDs.

This case report concludes that transconjunctival suturing of trabeculectomy scleral flap is an effective and non-invasive treatment to raise IOP and prevent visual loss from hypotony maculopathy after trabeculectomy with an overfiltering bleb.