Direct Cyclopexy after Persistent Hypotony as a Complication after Cyclodialysis and Goniotomy

2015 ◽  
pp. 85-87
Author(s):  
U. Demeler
Keyword(s):  
Persistent Hypotony

Ultrasound Biomicroscopy in the Diagnosis of Persistent Hypotony After Vitrectomy

1997 ◽  
Vol 123 (5) ◽  
pp. 711-713 ◽  
Author(s):  
Atsushi Minamoto ◽  
Kensuke E. Nakano ◽  
Seiji Tanimoto ◽  
Hideaki Mizote ◽  
Yoshifumi Takeda
Keyword(s):  
Ultrasound Biomicroscopy ◽  
Persistent Hypotony

scholarly journals Ciliochoroidal effusion with persistent hypotony after trabectome surgery

2015 ◽  
Vol 63 (3) ◽  
pp. 272 ◽  
Author(s):  
EssamA Osman ◽  
Faisal AlMobarak
Keyword(s):  
Ciliochoroidal Effusion ◽  
Trabectome Surgery ◽  
Persistent Hypotony

scholarly journals Persistent hypotony in cyclodialysis: When direct cyclopexy fails-role of vitrectomy

2018 ◽  
Vol 30 (2) ◽  
pp. 131
Author(s):  
Pramod Shetty ◽  
Jacob Chacko ◽  
Joel Anthony ◽  
Krishnaprasad Kudlu
Keyword(s):  
Persistent Hypotony

scholarly journals Persistent hypotony after primary trabeculectomy with mitomycin C

2000 ◽  
Vol 63 (3) ◽  
pp. 179-183
Author(s):  
Viviane R.F. Guedes ◽  
Ruthanne B. Simmons ◽  
Helena M. Pakter ◽  
Richard J. Simmons
Keyword(s):  
Mitomycin C ◽  
Persistent Hypotony

Late Hypotony

2013 ◽  
Author(s):  
Matthew G. McMenemy
Keyword(s):  
Pediatric Population ◽  
Late Complication ◽  
Underlying Disease ◽  
Early Postoperative Period ◽  
Santa Ana ◽  
Shunt Group ◽  
Corneal Decompensation ◽  
Group 3 ◽  
Tube Versus ◽  
Persistent Hypotony

As with all surgeries, numerous complications can occur with tube shunts; one particular complication is hypotony. Early hypotony is defined as intraocular pressure (IOP) of less than 6 mm Hg and occurs before maturation of the fibrotic capsule around the tube shunt plate. The physiologic development of the capsule typically occurs during the first postoperative 4–6 weeks after implantation. Late hypotony can be defined as IOP of less than 6 mm Hg that occurs after the plate is encysted. Hypotony in and of itself may not require treatment unless secondary complications develop (see Chapter 10 and 34). Untreated, hypotony can result in shallowing or flattening of the anterior chamber, corneal decompensation (see Chapter 40), peripheral anterior synechiae, cataract, maculopathy (see Chapter 22), optic nerve edema, choroidal effusion or hemorrhage (see Chapter 6), and even endophthalmitis (see Chapter 42). Although hypotony is common in the early postoperative period, it is less common as a late complication. Knowing how to prevent and manage late hypotony is essential for long-lasting surgical success. Persistent hypotony is less common with tube shunts than with trabeculectomy. In the Tube Versus Trabeculectomy Study, of the 107 eyes in the tube group, none had persistent hypotony, whereas of the 105 eyes in the trabeculectomy group, 3 developed persistent hypotony. A pediatric population study comparing trabeculectomy with mitomycin-C (24 eyes) with Ahmed™ (New World Medical, Inc., Rancho Cucamonga, California) or Baerveldt® (Abbott Medical Optics, Inc., Santa Ana, California) shunts (46 shunts total) had one eye in the trabeculectomy group with late hypotony, while no eyes in shunt group developed persistent hypotony. WuDunn et al implanted 250 mm Baerveldt® devices in 108 patients, with 5 failing due to persistent hypotony. In all likelihood, late hypotony in the WuDunn et al study was due to either progression of underlying disease resulting in less aqueous production or secondary to another complication of shunt surgery. However, across the different types of shunts, the incidences of early and late hypotony are not significantly different.

Persistent hypotony after trabeculectomy: incidence and associated factors in the Collaborative Bleb-Related Infection Incidence and Treatment Study

2016 ◽  
Vol 60 (4) ◽  
pp. 309-318 ◽  
Author(s):  
Tomomi Higashide ◽  
Shinji Ohkubo ◽  
Yosuke Sugimoto ◽  
Yoshiaki Kiuchi ◽  
Kazuhisa Sugiyama
Keyword(s):  
Associated Factors ◽  
Infection Incidence ◽  
Persistent Hypotony

CYCLODIALYSIS INDUCED PERSISTENT HYPOTONY

Retina ◽  
2013 ◽  
Vol 33 (8) ◽  
pp. 1540-1546 ◽  
Author(s):  
M. Dutra Medeiros ◽  
Maurizio Postorino ◽  
Carolina Pallás ◽  
Cecilia Salinas ◽  
Carlos Mateo ◽  
...  
Keyword(s):  
Persistent Hypotony

Hypotony Maculopathy

2013 ◽  
Author(s):  
Robert L. Stamper
Keyword(s):  
Structural Changes ◽  
Vision Loss ◽  
Posterior Pole ◽  
Filtering Surgery ◽  
Success Rates ◽  
Vascular Abnormalities ◽  
Hypotony Maculopathy ◽  
Higher Doses ◽  
Persistent Hypotony

Hypotony is often defined as intraocular pressure (IOP) less than 6 mm Hg. It has been reported to occur after glaucoma filtering surgery in up to 42% of cases and is usually associated with overfiltration or wound leaks. Hypotony requiring revision, however, occurs in about 4% of filtering procedures. Hypotony can follow any IOP-lowering procedure or even “simple” cataract surgery. The advent of guarded filtering surgery has reduced the rate of hypotony significantly compared to full-thickness filtering surgery. Unfortunately in the quest to increase success rates by using adjunctive antifibrotic agents, such as mitomycin-C (MMC) or 5-fluorouracil (5-FU), that prevent fibrotic wound healing, the incidence has increased again. Higher doses of and longer exposure times to MMC are associated with a greater risk of hypotony. Most cases of hypotony are transient and self-limited to a few days or weeks after surgery. Transient hypotony does not seem to have any deleterious effect on long-term visual acuity. However, persistent hypotony may result in structural changes that can become permanent. Hypotony maculopathy is one such condition manifesting from persistent hypotony that can result in permanent vision loss. Hypotony maculopathy occurs in up to 10% of filtering operations with MMC or 5-FU and in about 10% of eyes with chronic hypotony. Maculopathy associated with hypotony was first described by Dellaporta. Some years later, Gass, using fluorescein angiography, better characterized the condition. In hypotony maculopathy, the sclera and choroid develop folds in the posterior pole, which can cause significant visual disturbances. The condition is recognized by characteristic striae or folds in the macular area that do not leak or stain with fluorescein. The posterior sclera appears partially collapsed, causing the folds. The axial length of the eye may be shortened after both filtering and tube shunt surgery and more so in patients with hypotony. The loss of vision is usually gradual after the hypotony has persisted for at least a month or more. Indocyanine green angiography has revealed some vascular abnormalities including vessel tortuosity and filling defects.

Conjunctival bleb compression as a treatment for hypotony post XEN45 implant in uveitic glaucoma

2019 ◽  
Vol 30 (1) ◽  
pp. 217-220
Author(s):  
Jonathan Thur Sian Yu ◽  
Leon Au
Keyword(s):  
Intraocular Pressure ◽  
Case Series ◽  
Retrospective Case ◽  
Uveitic Glaucoma ◽  
Inflammatory Status ◽  
Effective Option ◽  
Successful Resolution ◽  
Persistent Hypotony ◽  
Conjunctival Bleb

Purpose: Over-filtration and subsequent hypotony are recognised complications of penetrating glaucoma procedures, especially when augmented with antimetabolites. Patients with uveitis are especially at risk of hypotony and this can reduce the final acuity achieved, compromise surgical outcomes and adversely affect the inflammatory status. The incidence of hypotony following XEN45 implant insertion is higher for uveitic patients and we present a method of surgically addressing this hypotony with transconjunctival compression sutures that are placed over the overdraining XEN45 implant. Methods: We present a retrospective case series of consecutive uveitic glaucoma patients who had conjunctival compression sutures between 2015 and 2018 following XEN45 insertion, at the Manchester Royal Eye Hospital, UK. Two 9/0 nylon sutures were placed in a horizontal figure-of-eight conformation transconjunctivally across the overdraining bleb: one directly over the XEN45 implant and one at the posterior limit of the implant in order to restrict flow. Results: Three patients underwent conjunctival compression sutures following XEN45 implant-related hypotony and all three had successful resolution of their hypotony and visual symptoms. No patients required long-term topical agents to control their intraocular pressure. Conclusion: Conjunctival compression sutures are an effective option for addressing persistent hypotony following XEN45 implant insertion in patients with uveitic glaucoma.

scholarly journals Persistent Hypotony Associated with Immunosuppressive Therapy in Glaucoma Drainage Implant Surgery

2016 ◽  
Vol 7 (3) ◽  
pp. 410-415 ◽  
Author(s):  
Susana Duch ◽  
Elena Milla ◽  
Oana Stirbu ◽  
David Andreu
Keyword(s):  
Immunosuppressive Therapy ◽  
Microscopic Examination ◽  
Macroscopic Appearance ◽  
Implant Surgery ◽  
The Third ◽  
Capsular Formation ◽  
Persistent Hypotony

Purpose: To describe the histopathology of non-valved implant capsules in three cases of persistent postoperative hypotony after the restrictive tube ligature was released in patients receiving immunosuppressive therapy. Observations: The macroscopic appearance of the capsules 3 and 4 months postoperatively was immature and loose. Microscopic examination disclosed extremely irregular thin tissue, with thicknesses ranging from 0.02 to 0.6 mm, depending on the capsular location studied. Withdrawal of immunosuppressive therapy did not facilitate rebuilding of new capsules. Replacement with a valved implant device was necessary in two cases; the third case recovered with tapering of prednisone. Conclusions and Importance: The use of chronic systemic immunosuppressive therapy might interfere with capsular formation around the plates of drainage devices inducing persistent hypotony. In these cases, the use of valved implants might be safer.

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