Transconjunctival flap sutures: A novel technique to combat hypotony

ABSTRACT

Background: Hypotony secondary to overfiltration is a recognized complication following trabeculectomy. Persistent hypotony requires intervention . Purpose: We describe a modified version of placing conjunctival compression sutures directly over the scleral flap. Synopsis A 70-year-old male patient diagnosed with primary open angle glaucoma in both eyes underwent combined surgery in the right eye. On the tenth post-operative day, the patient presented with severe hypotony with 360? choroidal detachment. He was treated with corticosteroids and cycloplegics but developed hypotony maculopathy on the subsequent follow-up. Hence, he was further managed surgically by trans-conjunctival flap sutures to which he responded favorably with resolution of choroidal detachment and improvement in intraocular pressure and visual acuity. Highlights Transconjunctival suturing of the scleral flap is an effective and minimally invasive treatment to prevent visual loss from hypotony maculopathy for an overfiltering bleb following trabeculectomy.