Rotation Flap of Tenon's Capsule for Treating Hypotony

ABSTRACT

PURPOSE: To report a case of rotational flap of Tenon's capsule for hypotony with choroidal detachment occurring after trabeculectomy and needle revision (NR) of a nonfunctioning bleb. METHODS: An 15-year-old female, suffering acute angle-closure glaucoma with lens dislocation into anterior chamber, underwent pars plana vitrectomy, lensectomy, and intraocular lens scleral fixation. Three months later, trabeculectomy with mitomycin C (MMC) and NR with MMC were performed to decrease intraocular pressure (IOP). After 5th NR, hypotony with choroidal detachment occurred. Consequently, bleb revision and rotation flap of the autologous Tenon's capsule were performed. RESULTS: One week after surgery, IOP was 18 mmHg, and a diffuse bleb was formed. Choroidal detachment improved with remaining vascular tortuisity and chorioretinal folds. At five months, best corrected visual acuity was 0.5, IOP was 20 mmHg, vascular tortuisity decreased, and chorioretinal folds disappeared in the macula. CONCLUSIONS: Hypotony with choroidal detachment occurring after needle revision was treated effectively with bleb revision and rotation at flap of autologous Tenon's capsule.