How Do You Deal With Post-op Hypotony After Trabeculectomy?

March 12, 2009

When I am faced with bad hypotony (not the good hypotony where the IOP is 5, VA is 20/25 and cornea is clear) after a trab that lasts more than a few days and/or is getting worse (ugh…), there are two things that I like to do-

1. Inject viscoelastic into the anterior chamber. I always keep a vial of this stuff in the fridge. I don’t care why the eye is hypotonous- viscoelastic always helps. The decrease in filtration will help whether you have a small leak or over-filtration.

2. Buy one of those really big contact lenses from Westcon (the diameter is like 20mm). This also reduces filtration by putting pressure on the flap, and also helps seal small leaks.

If you have these two things in your office ( I know i do!), you’ll find yourself being much better able to deal with hypotony which, trust me, is going to happen. They really come in handy.




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