Hypotony Keratopathy Following Trabeculectomy.

Abstract:

PRECIS:Hypotony keratopathy is a potential complication of hypotony following trabeculectomy and successful treatment depends on increasing intraocular pressure (IOP). PURPOSE:To evaluate corneal decompensation in patients following trabeculectomy with adjuvant mitomycin C (MMC). We propose "hypotony keratopathy" as a descriptive term. METHODS:Patients with trabeculectomy and follow-up performed by the authors were included in this retrospective single-center study. Patients were included if they had evidence of corneal decompensation (Descemet membrane folds or corneal edema) the following trabeculectomy with MMC with concurrent hypotony. Outcome measures included best-corrected visual acuity, average IOP at time of diagnosis, and changes in central corneal thickness. Clinical outcomes for the treatment of hypotony keratopathy were noted when performed. RESULTS:A total of 14 eyes from 12 patients were included in the series. Hypotony developed an average of 5 years after trabeculectomy, and hypotony keratopathy was diagnosed 7.5 years after trabeculectomy. Hypotony keratopathy ranged from nonvisually significant Descemet membrane fold without increased corneal thickness to visually significant corneal edema. Best-corrected visual acuity decreased 0 to 6 Snellen lines after diagnosis of hypotony keratopathy. Lower IOP was associated with increased corneal thickness. Vision improved after trabeculectomy revision (6 eyes) and cataract extraction with an intraocular lens implant (1 eye) but did not improve after Descemet stripping automated endothelial keratoplasty (2 eyes). CONCLUSIONS:Hypotony keratopathy is a poorly described but potentially treatable complication of trabeculectomy with MMC. Hypotony keratopathy may be related to endothelial dysfunction secondary to hypotony.

journal_name

J Glaucoma

journal_title

Journal of glaucoma

authors

Camp AS,Weinreb RN

doi

10.1097/IJG.0000000000001425

subject

Has Abstract

pub_date

2020-02-01 00:00:00

pages

77-80

issue

2

eissn

1057-0829

issn

1536-481X

journal_volume

29

pub_type

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