Early hypotony after trabeculectomy

Abstract

The occurrence of early hypotony after trabeculectomy was analysed retrospectively in 60 glaucoma patients. Fifty-two per cent of the eyes had an intraocular pressure < or = 10 mmHg on the first postoperative day. In about one-third of the eyes, the intraocular pressure was < or = 5 mmHg at the first postoperative visit and in more than 70% of these eyes the hypotony was almost unchanged one week after operation. The hypotony one week after operation was not correlated to the age of the patients and the intraocular pressure at operation, nor to the glaucoma type, and showed no significant statistical dependence on the depth of anterior chamber and hyphema. The final untreated intraocular pressure and progression of the postoperative cataract were studied in four groups of patients, formed on the basis of the intraocular pressure level one week after operation: patients with marked hypotony, slight hypotony, normal pressure or with hypertension. The final untreated intraocular pressure in the eyes with early marked hypotony was not significantly different from the final untreated intraocular pressures in the slightly hypotonic and normotonic eyes. However, the untreated intraocular pressures in these three eye groups were significantly different from the untreated intraocular pressure in the eye group with hypertension. Fifty-two per cent of the eyes suffered from cataract progression during a mean follow-up period of 24 months. Postoperative cataract progression in the markedly hypotonic eyes was not significantly different from the cataract progression in the other groups of eyes.

Trabeculectomy with an active postoperative regimen: results and resource utilization

“…In the present study, complication rates during surgery and the postoperative period were few and comparable with those of other studies (Popovic 1995; Popovic & Sjöstrand 1999). Choroidal detachment has been described in 22–59% of patients after trabeculectomy (Popovic 1995, 1998). Leyland et al.…”

“…2001) Success rates have been satisfactory, but complications such as hypotony, cataract, blebitis, endophthalmitis, suprachoroidal haemorrhage, and early and late filtration failures occur occasionally (Watson et al. 1990; Popovic & Sjöstrand 1991; Popovic 1995, 1998; Mochizuki et al. 1997; Popovic & Sjöstrand 1999; Singh et al.…”

Otago Glaucoma Surgery Outcome Study: long‐term results of 841 trabeculectomies

“…This series confirmed trabeculectomy as being a safe operation with a low rate of postoperative complications. Early postoperative hypotony (38%) was within the range of 24–39% reported in various studies using differing definitions 20–23 . In this series early postoperative hypotony was not associated with an increased rate of failure, which concurs with some 20,21 but not all reports 22,23 …”

Early Experience with the New XEN63 Implant in Primary Open-Angle Glaucoma Patients: Clinical Outcomes

“…Avoidance of hypotony in the early post-operative phase following glaucoma drainage device surgery is paramount if serious complications are to be avoided. Hypotony in the early postoperative period is a common and significant complication that has been associated with delayed visual recovery following trabeculectomy [32,33]. The reason why early post-operative complications are lower than in trabeculectomy may be due to the fact that the pre-determined lumen allows for a much more controlled outflow as compared to the traditional filtration surgery.…”