Ciliochoroidal effusion with persistent hypotony after trabectome surgery

Abstract

The trabectome is a novel form of ab interno trabeculectomy that ablates and remove the trabecular meshwork and the inner wall of Schlemm's canal and subsequently expose the natural drainage pathway (the collector channels) to aqueous humor. Complications associated with the trabectome are few and among them is transient hypotony. We report a case of a prolonged ciliochoroidal effusion with hypotony after ab interno trabeculectomy using the trabectome with cyclodialysis cleft detected by 80 MHz ultrasound biomicroscopy in a previously neither nonoperated nor traumatized eye. Transient hypotony has been reported after the trabectome surgery. Very few cases were associated with inadvertent intraoperative cyclodialysis, but there are no cases of prolonged hypotony with ciliochoroidal effusion with cyclodialysis. In our case, associated transient intraoperative and postoperative hypotony with a history of chronically high pressure along with the possible contribution of low-grade postoperative inflammation may have precipitated the ciliochoroidal effusion with prolonged hypotony associated with cyclodialysis.

Vitamin D Deficiency in Rheumatoid Arthritis and Vitamin D Levels that vary with Rheumatoid Arthritis Severity: An Indian Study

“…Ab-interno Trabeculectomy with Trabectome (Neomedix Corp) remains a promising, minimally invasive glaucoma procedure that decreases IOP by carefully ablating and removing some of the Trabecular meshwork and exposing collector channels, which facilitates aqueous humor outflow. 4,5 The Trabectome is a surgical tool that was approved for use by the US Food and Drug Administration in 2004, 6 and gained popularity for the treatment of various forms of glaucoma. 7 The Trabectome procedure presents a viable alternative to traditional trabeculectomy because of the absence of an external filtering bleb.…”

Continuous ab interno repairing of traumatic cyclodialysis cleft using a 30-gauge needle in severe ocular trauma: a clinical observation

“…Persistent hypotony may even result in eyeball atrophy [2]. Cyclodialysis cleft is the most common complication in closed globe injuries, with an incidence of 1 to 11% [3]; it occasionally occurs in open globe injuries and iatrogenic injuries [4–6]. In this study, 15 eye injuries were mechanical eye injuries, of which 4 were open globe injuries and 11 were closed globe injuries.…”

A Case of Cyclodialysis after Microhook Trabeculotomy Treated with Vitreous Surgery

“…A few treatment reports have been published concerning patients with prolonged low intraocular pressure and reduced vision after trabeculotomy. Among these, there have been reports of conventional trabeculotomy and postoperative reports of MIGS, post-Trabectome, and the Kahook Dual Blade technique [ 3 , 4 , 5 , 6 , 7 , 8 , 9 ].…”