Uveal effusion after trabeculectomy: Management challenges

Abstract

Purpose: To discuss the causes and risk factors of uveal effusion after trabeculectomy and to describe the management of this complication. Methods: This observational retrospective case series included 5 consecutive cases of uveal effusion that developed after trabeculectomy with intraoperative 5‐FU. All patients underwent ophthalmological examination including best corrected visual acuity (BCVA) measurement, anterior segment and fundus examinations. Fundus photography, B‐scan ultrasonography and Swept Source optical coherence tomography (SS‐OCT) were used to detect and monitor choroidal detachment and hypotony maculopathy. Anterior segment optical coherence tomography (AS‐OCT) was performed to assess iridocorneal angle opening and anterior chamber depth. Results: Four men and one woman were included. Mean age was 48.8 ± 15.1 y. One patient had nanophtalmia confirmed by B‐scan ultrasonography while four patients had postoperative hypotonia caused by overfiltration (3 cases) and bleb leak (1 case). All patients received corticosteroids and cycloplegics associated with a reformation of the anterior chamber and in one case we performed bleb revision. We showed resolution of the choroidal effusion, normalization of the ocular hypertension and restoration of visual acuity in all cases. Conclusions: Uveal effusion after trabeculectomy occurs in 3%–34% of cases. Its management can be challenging and requires close monitoring. Conservative management can overcome choroidal detachment, restore visual acuity and avoid aggressive surgery. References. 1. Schrieber C, Liu Y. Choroidal effusions after glaucoma surgery. Current Opinion in Ophthalmology. 2015; 26(2): 134–42. 2. Senthikumar VA, Michra C. Ultra‐widefield image of choroidal detachment after combined glaucoma filtration surgery. Indian J Ophthalmol. 2020; 68(8): 1669.