Rapid visual recovery and long-term intraocular pressure control after donor scleral patch grafting for trabeculectomy-induced hypotony maculopathy

Abstract

Purpose: To report on a 21-year-old man who had persistent hypotony maculopathy eight months after trabeculectomy with mitomycin C.

Methods: He was treated by excising the filtering bleb, placing a donor scleral patch graft over the trabeculectomy site, and bringing conjunctiva superior to the previous bleb over the patch graft.

Results: He had rapid resolution of his hypotony accompanied by an increase in visual acuity from 4/200 preoperatively to 20/80 at one day, and 20/20 at three months postoperatively. He also established and maintained a filtration bleb which kept his intraocular pressure in the mid teens without the use of medication.

Conclusion: Scleral patch grafting may provide rapid resolution of visual loss secondary to hypotony maculopathy.