Cataract Extraction as a Means of Treating Postfiltration Hypotony Maculopathy

Sibayan, Santiago Antonio B; Igarashi, Sachiko; Kasahara, Niro; Montenegro, Martha H; Simmons, Richard J.; Simmons, Robert B.; Smith, Thomas J.

doi:10.3928/1542-8877-19970301-13

Cited by 11 publications

References 11 publications

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Effect of Phacoemulsification Surgery on Hypotony Following Trabeculectomy Surgery

Doyle¹

2000

Arch Ophthalmol

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To review the effect of phacoemulsification surgery in eyes with chronic hypotony following trabeculectomy with mitomycin C. Design: Retrospective analysis of all eyes that underwent phacoemulsification surgery for symptomatic cataracts and had a preoperative diagnosis of chronic hypotony (intraocular pressure [IOP] Յ6 mm Hg) for at least 6 months following trabeculectomy with mitomycin C. Each case had at least 6 months' follow-up after the phacoemulsification surgery. Setting: A tertiary care referral center. Intervention: Clear cornea phacoemulsification surgery, with minimal perioperative anti-inflammatory medication and retention of viscoelastic in eyes at case conclusion. Main Outcome Measures: Intraocular pressure, visual acuity, and complications. Results: Nine eyes of 9 patients were identified. Mean preoperative IOP was 4.2 ± 1.4 mm Hg; the mean postoperative IOP was 7.3 ± 2.8 mm Hg (P=.009). Intraocular pressure increased in all but 2 eyes. One of these 2 eyes experienced an acutely elevated IOP (34 mm Hg) on postoperative day 4, which dropped back to preoperative levels after trabeculectomy flap needling. Mean preoperative visual acuity was 20/300; mean postoperative visual acuity was 20/40. Conclusion: Phacoemulsification surgery may be associated with a statistically significant elevation in IOP in previously filtered eyes with hypotony, resulting in resolution of hypotony in some of these challenging cases.

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Effect of Phacoemulsification Surgery on Hypotony Following Trabeculectomy Surgery

Doyle¹

2000

Arch Ophthalmol

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Cataract Surgery in the Hypotonous Eye

Ghodasra

Johnson

2009

Cataract Surgery in the Glaucoma Patient

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Bleb Revision for Resolution of Hypotony Maculopathy Following Primary Trabeculectomy

Bitrian

Song

2014

American Journal of Ophthalmology

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PURPOSE To describe a surgical method of bleb revision for hypotony maculopathy, to evaluate its long-term efficacy, and to define the relationship between the duration of hypotony maculopathy and visual acuity (VA) outcomes. DESIGN Noncomparative retrospective case series. METHODS Medical records of 33 patients with hypotony maculopathy who underwent primary bleb revision between June 1999 and September 2012 by a single surgeon at an academic medical center were reviewed. Hypotony maculopathy was characterized by the presence of a decrease in VA, retinal striae, and macular edema in the setting of decreased intraocular pressure (IOP) after glaucoma filtering surgery. The main outcome measure was final logMAR VA after bleb revision at 6 and 12 months. RESULTS Thirty-three eyes of 33 patients were followed for 4.68 ± 3.56 years (range 0.55–12.69 years). Mean duration of hypotony maculopathy was 4.98 ± 8.93 months. LogMAR VA improved from 0.78 ± 0.40 at baseline to 0.34 ± 0.34 (P < .001) 6 months after bleb revision and to 0.45 ± 0.55 (P < .001) 12 months after bleb revision. Spearman rank coefficient (rs) correlating duration of hypotony and BCVA at both 6 and 12 months was significant (P = .015 and rs = 0.426, P = .028 and rs = 0.416, respectively). Mean IOP increased from 3.51 ± 2.27 mm Hg to 12.06 ± 4.06 mm Hg (P < .001) at 12 months. Fifty-two percent were on no antiglaucoma medications at last follow-up. Five eyes (15%) required a second bleb revision to correct persistent hypotony maculopathy. CONCLUSION Surgical repair for hypotony maculopathy provided a significant improvement in VA at 6 and 12 months. Surgical bleb revision is associated with good long-term control of IOP and improved VA in eyes with hypotony maculopathy after previous glaucoma filtering surgery.

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Cataract Extraction as a Means of Treating Postfiltration Hypotony Maculopathy

Cited by 11 publications

References 11 publications

Effect of Phacoemulsification Surgery on Hypotony Following Trabeculectomy Surgery

Effect of Phacoemulsification Surgery on Hypotony Following Trabeculectomy Surgery

Cataract Surgery in the Hypotonous Eye

Bleb Revision for Resolution of Hypotony Maculopathy Following Primary Trabeculectomy

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