Purchase this article with an account.
K.P. Bashford, M.B. Shields, G. Shafranov; Bleb Revision for Hypotony Maculopathy after Trabeculectomy . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1188.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: To assess the efficacy of a standardized bleb revision technique with regard to improvement in intraocular pressure and visual acuity after hypotony maculopathy and to evaluate the influence of duration of hypotony on visual outcome. Methods: Retrospective review of a series of patients who underwent a standard technique for bleb revision for hypotony maculopathy (IOP less than 6 and loss of 2 or more lines of central vision) following trabeculectomy. Bleb revision included excision of avascular bleb tissue, dissection posteriorly between conjunctiva and Tenons capsule, and advancement and suturing of the conjunctiva at the limbus. Results: Twelve patients were included in the study. The average age was 49.5 (range 23-78). Seven were female. The initial visual acuities before trabeculectomy were all 20/30-2 or better. The average intraocular pressure before trabeculectomy was 24.5 mmHg ±12.4. The average lowest IOP at least seven days after trabeculectomy was 1.2 mmHg ±0.7 and patients lost an average of 4.2 lines of acuity . Final intraocular pressures after bleb revision averaged 12.3 mmHg ±4.9. Compared to baseline just prior to bleb revision, all patients regained two or more lines of visual acuity (average 4.3 ±2.7), with five returning to the pre-trabeculectomy level. The duration of hypotony prior to bleb revision was 1-18 months (average 7.3 month) with no correlation between duration and visual outcome. Conclusion: Bleb revision for hypotony maculopathy following trabeculectomy is an effective technique for raising intraocular pressure and limiting visual acuity loss, which is not influenced by duration of hypotony within the time frame of the study.
This PDF is available to Subscribers Only