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Anjella Zaringhalam, III, Elena Bitrian, Diem Bui, Suyeon Ahn, Joseph Caprioli; Visual Acuity Improvement After Bleb Revision for Hypotonous Maculopathy. Invest. Ophthalmol. Vis. Sci. 2011;52(14):622.
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To report the long-term efficacy, safety and visual acuity changes after bleb revision for hypotonous maculopathy.
This is a non comparative retrospective case series of hypotonous maculopathy that underwent a primary bleb revision between June 1999 and June 2010 by a single surgeon. Hypotonous maculopathy was characterized by low IOP, loss in visual acuity and retinal striae. Patients with less than 3 months of follow-up or that underwent a prior bleb revision were excluded. Surgery involved resection of necrotic conjuctiva, resuture of the scleral flap with 10-0 nylon, use of pericardium patch graft in some cases and conjunctival advancement.
Thirty-three eyes of 33 patients (age 66.65 ± 14.40 years) were followed for an average of 2.74 ± 3.07 years (range 3 months - 9.5 years). Forty-five percent were female and 3 (9%) presented with choroidals as well as macula striae. After bleb revision, the mean baseline intraocular pressure (IOP) increased from 3.16 ± 1.94 mmHg to 11.71 ± 5.24 mm Hg at the last follow-up (P<0.001). Visual acuity also improved from 0.30 ± 0.21 to 0.53 ± 0.23 (P<0.001). Seventy-five percent of patients were on no antiglaucoma drops at last follow-up. Four cases (12 %) required a second bleb revision to resolve the hypotonous maculopathy.
Surgical repair for hypotony maculopathy was associated not only with improvement in IOP, but also in visual acuity, both at short and long term of follow-up. Bleb revision is an effective procedure with good long-term control of IOP and improvement of visual acuity in eyes with hypotonous maculopathy.
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