Resuturing the Scleral Flap Leads to Resolution of Hypotony Maculopathy

Hypotony maculopathy

“…Schwartz et al. (1996) reported four eyes that underwent trabeculectomy using topical mitomycin C and developed hypotony maculopathy unresponsive to non‐surgical therapies.…”

“…Sometimes, the above-mentioned measures used to treat hypotony secondary to overfiltration do not reverse the problem because failure of scleral healing is the underlying cause. In these cases, resuturing the scleral flap or placing a scleral patch over the original flap is effective in reversing hypotony and restoring VA, while still maintaining some degree of filtration (Cohen et al 1995;Schwartz et al 1996;Halkiadakis et al 2005;Harizman et al 2005). Schwartz et al (1996) reported four eyes that underwent trabeculectomy using topical mitomycin C and developed hypotony maculopathy unresponsive to non-surgical therapies.…”

Efficacy and safety of transconjunctival scleral flap resuturing for hypotony after glaucoma filtering surgery

“…In comparison with the above techniques, resuturing of the scleral flap by reopening the conjunctival flap [9,13,18,23,28,35,36,38] is the most direct and reliable method to repair the bleb, and is a method aiming to resolve excess filtration by directly reducing the filtration below the scleral flap. However, this surgery is invasive and may cause conjunctival injury, bleb adhesion and infection.…”

“…Many methods for the management of hypotony have been reported, including intrableb injection of autologous blood, [14][15][16][17][18][19] laser irradiation of the bleb, [20][21][22][23] bleb cryotherapy, [3,4,18,[23][24][25][26][27] trichloroacetic acid treatment, [4,18,28,29] compression eye patch, [30][31][32] contact lens wearing, [18,33] compression suture, [17,19,34] bleb excision, [4,35,36] free conjunctival autograft, [37] scleral patch grafting, [26] and scleral flap resuturing by reopening the conjunctival flap [9,13,18,23,28,35,36,38]. However, none of the above methods decreases the effects of excess filtration or resolves hypotony with high reliability and safety.…”

Effect of Diode Laser Application with G-Probe on Ocular Hypotony after Trabeculectomy with Mitomycin-C

“…2 Therefore the procedures to produce inflammation at the bleb site, and thereby reduce filtration have been suggested as the treatment of choice. 17 Different therapeutic methods have been used for this purpose, including bandage contact lens, 18 trichloracetic acid, 19 and argon 11,20 or Nd:YAG laser, 9,21 compression suture, 22 and cataract surgery, 8,23 resuturing the scleral flap, 24 covering the sclerostomy with a tissue flap, 25 pars plana vitrectomy, and silicon oil placement. 26 In Lynch et al's 21 study on 14 eyes with ocular hypotony after trabeculectomy continuous-wave Nd:YAG laser was applied to the overfunctioning and large blebs.…”