April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Visual Acuity Improvement After Bleb Revision for Hypotonous Maculopathy
Author Affiliations & Notes
  • Anjella Zaringhalam, III
    Jules Stein Eye Institute, UCLA, Los Angeles, California
  • Elena Bitrian
    Glaucoma,
    Jules Stein Eye Institute, UCLA, Los Angeles, California
  • Diem Bui
    Glaucoma,
    Jules Stein Eye Institute, UCLA, Los Angeles, California
  • Suyeon Ahn
    Glaucoma,
    Jules Stein Eye Institute, UCLA, Los Angeles, California
  • Joseph Caprioli
    Glaucoma,
    Jules Stein Eye Institute, UCLA, Los Angeles, California
  • Footnotes
    Commercial Relationships  Anjella Zaringhalam, III, None; Elena Bitrian, None; Diem Bui, None; Suyeon Ahn, None; Joseph Caprioli, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 622. doi:
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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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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To report the long-term efficacy, safety and visual acuity changes after bleb revision for hypotonous maculopathy.

Methods: : 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.

Results: : 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.

Conclusions: : 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.

Keywords: intraocular pressure • wound healing 
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